BACKGROUND AND OBJECTIVES: Ultrasound-guided (USG) ankle block has been described; however, its clinical efficacy compared with conventional anatomic landmark-guided (ALG) techniques remains undetermined. METHODS: We performed a 6-year retrospective cohort study of all ankle blocks performed for foot surgery and extracted demographic, intraoperative, and postoperative outcome data. We divided blocks into 2 groups for comparison, depending on whether they were performed using an ALG technique or a USG technique. RESULTS: We identified 655 patients who received unilateral ankle block and 58 patients who received bilateral ankle block; we analyzed these separately. Trainees performed most blocks (approximately 80%). In patients receiving unilateral ankle block, successful surgical anesthesia was more likely in the USG group (84% versus 66%, P < 0.001). Patients in the ALG group were more likely to require supplemental local anesthesia (10% versus 5%, P = 0.04), unplanned general anesthesia (17% versus 7%, P = 0.001), or supplemental fentanyl (18% versus 9%, P = 0.002). Postanesthetic care unit pain scores were similar between groups. However, patients in the ALG group were more likely to receive intravenous opioids (21% versus 12%, P = 0.01), and they received a higher mean opioid dose (10.6 versus 8.7 mg intravenous morphine, ALG versus USG, P = 0.022). In patients receiving bilateral ankle block, successful surgical anesthesia was also more likely in the USG group (84% versus 57%); however, this was not statistically significant because of the small sample size. CONCLUSIONS: This study demonstrates that the USG technique of ankle block improves clinical efficacy compared with a conventional ALG technique, particularly in the hands of less-experienced practitioners.
BACKGROUND AND OBJECTIVES: Ultrasound-guided (USG) ankle block has been described; however, its clinical efficacy compared with conventional anatomic landmark-guided (ALG) techniques remains undetermined. METHODS: We performed a 6-year retrospective cohort study of all ankle blocks performed for foot surgery and extracted demographic, intraoperative, and postoperative outcome data. We divided blocks into 2 groups for comparison, depending on whether they were performed using an ALG technique or a USG technique. RESULTS: We identified 655 patients who received unilateral ankle block and 58 patients who received bilateral ankle block; we analyzed these separately. Trainees performed most blocks (approximately 80%). In patients receiving unilateral ankle block, successful surgical anesthesia was more likely in the USG group (84% versus 66%, P < 0.001). Patients in the ALG group were more likely to require supplemental local anesthesia (10% versus 5%, P = 0.04), unplanned general anesthesia (17% versus 7%, P = 0.001), or supplemental fentanyl (18% versus 9%, P = 0.002). Postanesthetic care unit pain scores were similar between groups. However, patients in the ALG group were more likely to receive intravenous opioids (21% versus 12%, P = 0.01), and they received a higher mean opioid dose (10.6 versus 8.7 mg intravenous morphine, ALG versus USG, P = 0.022). In patients receiving bilateral ankle block, successful surgical anesthesia was also more likely in the USG group (84% versus 57%); however, this was not statistically significant because of the small sample size. CONCLUSIONS: This study demonstrates that the USG technique of ankle block improves clinical efficacy compared with a conventional ALG technique, particularly in the hands of less-experienced practitioners.
Authors: Richard L Kahn; Scott J Ellis; Jennifer Cheng; Jodie Curren; Kara G Fields; Matthew M Roberts; Jacques T YaDeau Journal: HSS J Date: 2017-12-07
Authors: C Rothe; C Steen-Hansen; M H Madsen; L H Lundstrøm; R Heimburger; K E Jensen; K H W Lange Journal: Anaesthesia Date: 2015-02-27 Impact factor: 6.955
Authors: Anuj Bhatia; Vera Bril; Richard T Brull; Anthony Perruccio; Duminda Wijeysundera; Sabeeh Alvi; Johnny Lau; Rajiv Gandhi; Nizar Mahomed; Aileen M Davis Journal: BMJ Open Date: 2016-06-22 Impact factor: 2.692
Authors: Anuj Bhatia; Vera Bril; Richard T Brull; Anthony V Perruccio; Duminda N Wijeysundera; Johnny Lau; Rajiv Gandhi; Nizar Mahomed; Aileen M Davis Journal: Pain Rep Date: 2021-07-13