Continuous popliteal block for postoperative analgesia in total ankle arthroplasty.
BACKGROUND
Total ankle arthroplasty is associated with severe postoperative pain. Development of analgesic techniques such as a block with continuous infusion at the popliteal level has been shown to result in good pain control, a decrease in the use of rescue analgesia and a low rate of complications. We reviewed our experience with this method of analgesia in patients who underwent total ankle arthroplasty.


METHODS
A prospective study of 30 patients undergoing total ankle arthroplasty was carried out. Twenty-two of these received and maintained a block at the popliteal level with a continuous infusion of bupivacaine, while the remaining eight received no such block.


RESULTS
The visual analog scale evaluation (VAS) showed a significant improvement in pain control in the group with the popliteal block after 6, 12, 18, and 24 hours postsurgery, with pain levels peaking and being most different between 6 and 12 hours postsurgery for the two groups. The group with the popliteal block also exhibited a significantly lower consumption of morphine and a greater degree of patient satisfaction.


CONCLUSIONS
The block with continuous infusion at the popliteal fossa was a safe technique for total ankle arthroplasty postoperative analgesia, which provided good pain control, a lower requirement of opiates and a higher level of patient satisfaction.
Instituto Traumatológico, Foot and Ankle Service, San Martin 771, Santiago de Chile 8340220, Chile.
Jorge
J
Gallardo
Leonardo
L
Lagos
Christian
C
Bastias
Hugo
H
Henríquez
Giovanni
G
Carcuro
Marcos
M
Paleo
D000701:Analgesics, Opioid / Q000627:therapeutic use; D000779:Anesthetics, Local / Q000008:administration & dosage*; D058737:Arthroplasty, Replacement, Ankle; D002045:Bupivacaine / Q000008:administration & dosage; D006801:Humans; D007262:Infusions, Intravenous; D009020:Morphine / Q000627:therapeutic use; D009407:Nerve Block / Q000379:methods*; D010147:Pain Measurement; D010149:Postoperative Pain / Q000517:prevention & control*; D017060:Patient Satisfaction; D011446:Prospective Studies; D012584:Sciatic Nerve
D000701:Analgesics, Opioid; D000779:Anesthetics, Local; D009020:Morphine; D002045:Bupivacaine