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Background and Aims There has been interest in investigating the optimal anesthetic method for Total Ankle Arthroplasty (TAA) to optimize perioperative outcomes. Saphenous block and sciatic nerve block are usually performed and have been extensively described. We report a case in which TAA was performed on both legs at different times. For the first surgery, a sciatic nerve block at the knee was performed for postoperative analgesia. However, for the second surgery, both a saphenous block and a sciatic nerve block were performed. The objective is to evaluate any improvement in postoperative pain control by adding a saphenous block.

Methods We present the case of a woman who underwent Total Ankle Arthroplasty (TAA) on both legs at different times. The surgeries were performed by the same surgeon under intradural anesthesia with Hyperbaric Bupivacaine 10 mg plus Fentanyl 10 mcg, Paracetamol and metamizol as postoperative analgesia. All blocks were performed using ultrasound. We evaluated postoperative pain control using the visual analogue scale (VAS) at 1, 6, and 24 hours after surgery.

Results We found no differences in pain control during the postoperative period. The VAS scores were 0 out of 10 at 1 hour, 2 out of 10 at 6 and 24 hours after surgery.

Conclusions Despite the absence of differences in postoperative pain control in this case, according to the results obtained by Bjørn S et al., most patients benefit from a saphenous block. We still recommend performing it due to its simplicity and minimal time consumption.