Combined Popliteal Catheter With Single-Injection vs Continuous-Infusion Saphenous Nerve Block for Foot and Ankle Surgery

Abstract

Level II, prospective cohort study.

Evidence-Based Orthopaedic Post-Operative Opioid Prescribing Recommendations Following Foot & Ankle Surgery

“…Patients in the continuous catheter group consumed fewer opioids, reported less pain, and were more satisfied with their pain management than patients in the single shot group. 46 In a study on utilizing regional anesthesia as a long-acting popliteal block consisting of dexamethasone and bupivacaine in outpatient foot and ankle surgeries, patients utilized less than half (mean 22.5 pills used of 55.5 pills prescribed) of the opioid medications prescribed postoperatively. 47 In a systematic review of randomized controlled trials, there was no clear analgesic superiority with the use of proximal peripheral nerve blocks (i.e., At the hip) compared to popliteal nerve blocks, and popliteal sciatic nerve blocks provided a longer duration of analgesia compared to distal blocks at the ankle.…”

Regional anaesthesia: what surgical procedures, what blocks and availability of a “block room”?

“…Although superior results have been suggested in the prospective study with lesser postoperative opioid requirements in the case of dual catheter placement, that is, continuous popliteal and saphenous nerve block [116]. The placement of dual catheter was not without complications, four participants had neuropathic pain of whom two had improvement in the follow up period [116]. Another complication of this block is a risk of (persisting) drop foot when the common peroneal nerve is damaged [117].…”

“…This block is used in outpatient foot or ankle surgery, by blocking the nerves in the popliteal region and saphenous nerve region, with good postoperative pain relief up to 24 h [116]. Although superior results have been suggested in the prospective study with lesser postoperative opioid requirements in the case of dual catheter placement, that is, continuous popliteal and saphenous nerve block [116]. The placement of dual catheter was not without complications, four participants had neuropathic pain of whom two had improvement in the follow up period [116].…”

Response to “Letter Regarding: Combined Popliteal Catheter With Single-Injection vs Continuous-Infusion Saphenous Nerve Block for Foot and Ankle Surgery”

“…Thank-you to Dr Kendall for reading our study comparing the use of a dual-catheter (continuous popliteal and saphenous) to continuous popliteal catheter and single-injection saphenous nerve blocks in outpatient foot and ankle surgery. 1 We appreciate the comments and questions and hope the answers provided will help address any concerns.…”