International Journal of Medical and Dental Sciences

Open Access Open Access  Restricted Access Subscription Access

Comparative Analysis of Unilateral Subarachnoid Block with Ankle Block for Elective Foot Surgery


Affiliations
1 Department of Anesthesia and Critical Care, Punjab Institute of Medical Sciences Jalandhar, Punjab, India
2 Department of Community Medicine, Punjab Institute of Medical Sciences Jalandhar, Punjab, India
 

Background:There are many accepted anesthesia techniques for elective foot surgery ranging from general anesthesia to regional anesthesia, regional anesthesia being the preferred method. Regional anesthesia techniques employed for foot surgery includes subarachnoid block, epidural anesthesia and ankle block.

Objective: The present study is aimed at providing comparative analysis of ankle block with unilateral subarachnoid block for elective foot surgeries in terms of hemodynamic safety profile and post operative analgesia.

Material and Methods: Study includes prospective analysis of 80 ASA II and III patients who underwent elective foot surgery. Patients were randomly divided into two groups of 40 each, Ankle block group (AB) and Unilateral subarachnoid group (US). The parameters recorded for study includes systolic blood pressure, diastolic blood pressure, heart rate, visual analogue scale for pain severity, time of first analgesic need and the complications.

Results: There were minimal blood pressure changes and heart rate variability in AB group as compared to US group when compared with basal values (p<0.05). The time for first analgesic requirement is prolonged in AB group as compared to US group. The visual analogue scale score was assessed at 2nd, 4th and 6th hours for group AB were lowered as compared to group US (p < 0.05).

Conclusion: Ankle block is associated with lesser hemodynamic variations and better postoperative analgesia as compared to unilateral subarachnoid block.


Keywords

Elective Foot Surgery, Unilateral Subarachnoid Block, Ankle Block, Hemodynamic Stability, Post Operative Analgesia.
User
Notifications
Font Size


  • Reilley TE, Gerhardt MA. Anesthesia for foot and ankle surgery. Clin Podiatr Med Surg 2002 Jan;19(1):125-47.

  • Lin R, Hingorani A, Marks N, Ascher E, Jimenez R, Mclntyre T, et al. Effects of anesthesia versus regional nerve block on major leg amputation mortality rate. Vascular 2013 Apr;21(2):83-6.

  • Latifzai K, Sites BD, Koval KJ.Orthopaedic anesthesia-part 2.Common techniques of regional anaesthesia in orthopaedics. Bull NYU Hosp Jt Dis 2008;66:306-16.

  • Williams BA, Spratt D, Kentor ML.Continuous nerve blocks for outpatient knee surgery. Tech Reg Anesth Pain Man 2004;8:76-84.

  • Erdine S. Future and education regional anesthesia. İstanbul: Nobel bookstores; 2005.p. 315-9.

  • Mineo R, Sharrock N. Venous levels of lidocaine and bupivacaine after midtarsal ankle block. RegAnesth 1992;17:47-9.

  • Auroy Y, Narchi P, Messiah A, Litt L, Rouvier B, Samii K. Serious complications related to regional anesthesia: results of a prospective survey in France. Anesthesiology 1997; 87:479-86.

  • Sarrfian SK, Ibrahim IN, Breihan JH. Ankle-foot peripheral nerve block for mid and forefoot surgery. Foot Ankle 1983;4:86-9.

  • Ozhan M, Orhan E, Kurklu M, Demiralp B, Suzer A, Cekmen N, Ozhan C. Comparision of peripheral nerve blocks,spinal anesthesia and general anesthesia for ambulatory surgery of the lower limb. Nobel Medicus 2012;8:73-80.

  • Casati A, Cappelleri G, Fanelli G, Borghi B, Anelati D, Berti M, et al. Regional anaesthesia for outpatient knee arthroscopy: A randomized clinical comparison of two different anaesthetic techniques. Acta Anaesthesiol Scand 2000;44:543-7.

  • Pilny J, Kubes J. Forefoot surgery under regional anesthesia. Acta Chir Orthop Traumatol Cech 2005;72:122-4.

  • Lee TH, Wapner KL, Hecht PJ, Hunt PJ. Regional anesthesia in foot and ankle surgery. Orthopedics 1996;19:577-80.

  • Urafalioglu A, Gokdemir O, Hanbeyoglu O, Bilal B, Oksuz G, Toker M, et al. A comparison of ankle block and spinal anesthesia for foot surgery. Int J Clin Exp Med 2015; 8(10):19388-93.

  • Studner O, Danninger T, Memtsoudis SG. Regional anesthesia in patients with significant comorbid disease. Minerva Anestesiol 2013 Nov; 79(11):1281-90.

  • Dexter F, Macario A. What is relative frequency of uncommon ambulatory surgery procedures performed in the United States with an anesthesia provider. Anesth Analg 2000;90: 1343-7.

  • Wooden SR, Sextro PB. The ancle block: Anatomical review and anesthetic technique. AANA J 1990;58:105-11.

  • Rudkin GE, Rudkin AK, Dracopoulos GC. Bilateral ankle blocks: a prospective auidit. ANZ J Surg 2005;75:39-42.

  • Hyderally H. Complications of spinal anesthesia. Mt Sinai J Med 2002;69(12):55-6.


Abstract Views: 262

PDF Views: 140




  • Comparative Analysis of Unilateral Subarachnoid Block with Ankle Block for Elective Foot Surgery

Abstract Views: 262  |  PDF Views: 140

Authors

A. P. Singh
Department of Anesthesia and Critical Care, Punjab Institute of Medical Sciences Jalandhar, Punjab, India
B. Singh
Department of Anesthesia and Critical Care, Punjab Institute of Medical Sciences Jalandhar, Punjab, India
A. Bhardwaj
Department of Anesthesia and Critical Care, Punjab Institute of Medical Sciences Jalandhar, Punjab, India
I. Singh
Department of Anesthesia and Critical Care, Punjab Institute of Medical Sciences Jalandhar, Punjab, India
P. Kaur
Department of Community Medicine, Punjab Institute of Medical Sciences Jalandhar, Punjab, India

Abstract


Background:There are many accepted anesthesia techniques for elective foot surgery ranging from general anesthesia to regional anesthesia, regional anesthesia being the preferred method. Regional anesthesia techniques employed for foot surgery includes subarachnoid block, epidural anesthesia and ankle block.

Objective: The present study is aimed at providing comparative analysis of ankle block with unilateral subarachnoid block for elective foot surgeries in terms of hemodynamic safety profile and post operative analgesia.

Material and Methods: Study includes prospective analysis of 80 ASA II and III patients who underwent elective foot surgery. Patients were randomly divided into two groups of 40 each, Ankle block group (AB) and Unilateral subarachnoid group (US). The parameters recorded for study includes systolic blood pressure, diastolic blood pressure, heart rate, visual analogue scale for pain severity, time of first analgesic need and the complications.

Results: There were minimal blood pressure changes and heart rate variability in AB group as compared to US group when compared with basal values (p<0.05). The time for first analgesic requirement is prolonged in AB group as compared to US group. The visual analogue scale score was assessed at 2nd, 4th and 6th hours for group AB were lowered as compared to group US (p < 0.05).

Conclusion: Ankle block is associated with lesser hemodynamic variations and better postoperative analgesia as compared to unilateral subarachnoid block.


Keywords


Elective Foot Surgery, Unilateral Subarachnoid Block, Ankle Block, Hemodynamic Stability, Post Operative Analgesia.

References





DOI: https://doi.org/10.18311/ijmds%2F2016%2F100598