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Background and Aims The use of peripheral nerve blocks (PNB) are common for outpatient complex foot and ankle surgery. These can either be single shot (sPNB) or continuous via a catheter (cPNB). They have been shown to reduce opioid consumption and post surgical pain. These commonly are popliteal (PoNB), femoral (FeNB) or adductor canal (AdNB). The purpose of this study was to determine the use of opioids after sPNB in complex foot and ankle surgery at the Tertiary Royal National Orthopaedic Hospital and determine whether patients may benefit from cPNB.

Methods This was a prospective audit. 20 patients who had received sPNB undergoing either an (1)ankle fusion, (2)ankle replacement or (3)complex procedures involving calcaneal osteotomies were included. The primary outcome was immediate release (IR) opioid use in the first 24 and 48 hours. The secondary outcomes were length of stay, pain scores and delay to discharge.

Results 18 patients (90%) received both a PoNB and FeNB or AdNB with two (5%) receiving PoNB alone. Nine patients (45%) required IR opioids in the first 24 hours. Three patients (15%) required IR opioids from 24 to 48 hours. Median length of stay was one day, with no delay to discharge secondary to pain.

Conclusions This has demonstrated that sPNB is an effective method of pain relief for complex foot and ankle surgery. Most patients did not require immediate release opioids, and there were no delays to discharge due to pain. Further studies with a larger sample size are required to determine whether specific patients may benefit from cPNB.