title: The efficacy of combined popliteal and ankle blocks in forefoot surgery.
abstract: BACKGROUND
  Postoperative pain following forefoot surgery can be difficult to control with oral analgesia. The aim of this study was to compare the efficacy of a combined popliteal and ankle block with that of an ankle block alone in providing postoperative analgesia following forefoot surgery.
  
  
  METHODS
  We performed a prospective, randomized, controlled single-blind study involving sixty-three patients, twenty-six of whom had a combined ankle and popliteal block and thirty-seven of whom had an ankle block alone. All patients underwent an elective osseous surgical procedure on the forefoot. Postoperative pain was evaluated with use of a visual analogue scale and a verbal response form. Patient satisfaction was also recorded.
  
  
  RESULTS
  The patients who had had a combined popliteal and ankle block had significantly less pain at six hours postoperatively (p = 0.011), twenty-four hours postoperatively (p < 0.001), and at discharge (p = 0.014). This group of patients also had higher satisfaction with pain relief.
  
  
  CONCLUSIONS
  A popliteal block in conjunction with an ankle block provides significantly better pain relief than does an ankle block alone in patients undergoing forefoot surgery.
authors.affiliation: rohitsamuel@hotmail.com
authors.forename: Rohit
authors.initials: R
authors.lastname: Samuel
authors.forename: Andrew
authors.initials: A
authors.lastname: Sloan
authors.forename: Kuntal
authors.initials: K
authors.lastname: Patel
authors.forename: Magdy
authors.initials: M
authors.lastname: Aglan
authors.forename: Aamir
authors.initials: A
authors.lastname: Zubairy
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000842:Ankle; D005260:Female; D005545:Forefoot, Human / Q000601:surgery*; D006801:Humans; D007717:Knee; D008297:Male; D008875:Middle Aged; D009407:Nerve Block / Q000379:methods*; D019637:Orthopedic Procedures; D010147:Pain Measurement; D010149:Postoperative Pain / Q000209:etiology / Q000517:prevention & control*; D017060:Patient Satisfaction; D011446:Prospective Studies; D016037:Single-Blind Method; D016896:Treatment Outcome