Safety and efficacy of forefoot surgery under ankle block anaesthesia.
BACKGROUND
Ankle block as the sole anaesthetic for forefoot surgery is not used uniformly throughout the UK despite obvious advantages and widespread use internationally.


OBJECTIVE
Evaluation of safety and effectiveness of performing elective forefoot surgery under ankle block anaesthesia alone in a pilot cohort of patients in a Scottish unit.


METHODS
Data were collected from 81 consecutive forefoot procedures (71 patients) using a standardised questionnaire including incremental pain assessment (0-10; 0 no pain, 10 severe pain).


RESULTS
Seven patients reported pain during surgery; average score 0.17. Average pain scores 6, 12, 24 and 48 h following surgery were 1.5, 3.09, 2.3 and 1.9, respectively. All patients were discharged home and walking on the same day.


CONCLUSIONS
Forefoot surgery under ankle block alone may be safe and effective. Anaesthesia obtained permitted routine forefoot procedures and provided lasting post-operative analgesia. Combined with intra-operative sedation, use of ankle tourniquet and same day discharge, it had very high patient acceptance and satisfaction.
Orthopaedic Specialty Registrar, Department of Trauma & Orthopaedics, Glasgow Royal Infirmary, UK.
D F
DF
Russell
A
A
Pillai
C S
CS
Kumar
D000328:Adult; D000368:Aged; D018686:Anesthetics, Intravenous / Q000627:therapeutic use*; D005260:Female; D018409:Foot Injuries / Q000188:drug therapy* / Q000503:physiopathology / Q000601:surgery; D006801:Humans; D008297:Male; D008874:Midazolam / Q000627:therapeutic use*; D008875:Middle Aged; D009407:Nerve Block / Q000379:methods; D010147:Pain Measurement; D010149:Postoperative Pain / Q000188:drug therapy*; D017060:Patient Satisfaction / Q000706:statistics & numerical data*; D010865:Pilot Projects; D011446:Prospective Studies; D011795:Surveys and Questionnaires; D013997:Time Factors; D014111:Tourniquets; D016896:Treatment Outcome
D018686:Anesthetics, Intravenous; D008874:Midazolam
Local anaesthesia; ankle block; ankle tourniquet; day surgery; forefoot surgery