Article Text
Abstract
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Background and Aims Surgical treatment of ankle fracture (AF) is associated with significate postoperative pain. The two peripheral nerve blocks (PNB) used more frequently to provide complete anesthesia/analgesia to the ankle are the sciatic popliteal nerve block (SPNB) and saphenous nerve block (SNB). These PNB may be used as de only anesthesia technique or may be combined with spinal or general anesthesia. The main objective of this study was to compare the postoperative pain scores of patients treated with SPNB and SPNB combined with SNB.
Methods We reviewed retrospectively 51 patients surgically treated to ankle fractures with PNB through the first 5 months of the year of 2023. Thirty-two had SPNB and 19 SPNB plus SNB. The primary outcomes were pain scores at day 1 (D1) and day 2 (D2) postoperatively using the visual analog scale (VAS) score.
Results Pain scores did not vary significantly when comparing the use of SPNB and SPNB plus SNB. The mean VAS score of SPNB group at D1 was 0.59 +/-
1.16 and of SPNB plus SNB group 0.42 +/- 1.02 (p=0.29). At D2 the mean VAS score of SPNB group was 0.81 +/- 1.44 and the SPNB plus SNB group 0,95+/- 1.43 (p=0.62).
Conclusions When combined with spinal anesthesia or general anesthesia SPNB may be sufficient to provide postoperative analgesia after AF surgery. The SNB may not add any postoperative analgesic benefit into this group of patients. The combination of SPNB plus SNB may be advantageous when surgery is performed only under regional anesthesia with PNB.