medigraphic.com

2013, Number 1

<< Back Next >>

Rev Mex Anest 2013; 36 (1)

Anesthetic efficacy of peripheral nerve blocks at ankle level in foot surgery

Ramírez-Gómez M, Schlufter-Stolberg RM, Chao-Rueda MI

Language: Spanish
References: 24
Page: 14-25
PDF size: 487.52 Kb.


ABSTRACT

Objective: To evaluate the quality and postoperative duration of analgesia for ankle blocks during foot surgery. Material and methods: After institutional ethical committee approval and obtaining informed written consent from each patient; 150 patients, American Society of Anesthesiologists (ASA) physical status I to III, scheduled for foot and ankle surgery were included in a prospective, descriptive, longitudinal and analytical trial. The complete ankle block included: 1) posterior tibial nerve, 2) peroneal nerve-deep and superficial, saphenous nerve, 3) sural nerve. All under three combinations of local anesthetics (lidocaine, lidocaine-bupivacaine, lidocaine-ropivacaine) with a total volume of 15-25 mL. The duration of postoperative analgesia and anesthesia was evaluated. Results: With an average age of 57.5 years, primarily male and classified as ASA III according to the American Society of Anesthesiologists (ASA) due to diabetes mellitus, the main surgery performed was foot debridement in a 40.9%. The transoperative anesthesia for surgery was 100% successful for all three block combinations. The duration of analgesia was an average of 12 hours, with an visual analogical scale (VAS) score of 4.3 (tolerable pain). There was no significant differences regarding gender at 12 hours (p = 0.11), or at 24 hours (p = 0.23) and regarding the use of the different local anesthetics, there were no significant differences at 12 hours (p = 0.82) or 24 hours (p = 0.66). Conclusions: The ankle block for foot surgery constitutes a fine option for safe anesthesia. It provides a postoperative analgesia qualitatively significant for up to 12 hours.


REFERENCES

  1. Rawal N. Analgesia en cirugía mayor ambulatoria. Bristish Journal of Anesthesia 2001;87:73-87.

  2. Davis JE. Centro de cirugía ambulatoria mayor y su desarrollo; clínicas quirúrgicas de Norteamérica, 1987. Vol. 4. pp 685.

  3. Alvarado GFJ, Vega SE. Cirugía ambulatoria, una opción para mejorar la calidad de la atención. Experiencia de 15 años. Rev Esp Médico-Quirúrgicas 2006;3:34-37.

  4. Orkin FK. Anestesia ambulatoria: Pasado, presente y futuro. Clin Anestesiol N Am 1996;4:535-549.

  5. Amelio CG. Anestesia endovenosa en el servicio de cirugía ambulatoria. Rev Mex de Anest 2006;29:100-105.

  6. Vázquez BR, Gómez GE, Sánchez CR. Cirugía ambulatoria bajo anestesia intraarticular en el manejo del hallux valgus. Informe de 54 pacientes. Rev Mex Ortop Traum 2001;15:154-161.

  7. Steele S, Klein S, D’Ercole F, Greengrass R, Gleeson D. A new continuous catheter delivery system. Anesth Analg 1998;86:228.

  8. Hadzic A, Vloka JD. Bloqueos de nervios periféricos para cirugía ambulatoria de la extremidad inferior. Journal of Nysora, 19.03.2009, www.nysora.com

  9. Myerson MS, Ruland CM, Allon SM. Regional anesthesia for foot and ankle surgery. Foot Ankle 1992;13:282-8.

  10. Adriani J. Labat’s Regional Anesthesia. Techniques and Clinical Applications. 3rd ed. Philadelphia: W. B. Saunders Co; 1967. p. 321-324.

  11. White P. The role of non-opioid analgesic techniques in the management of pain after ambulatory surgery. Anesth Analg 2002; 94:577-585.

  12. García Camarero EJ. Bloqueos regionales en dolor postoperatorio. En: Andrés J. Puesta al día en anestesia regional y tratamiento del dolor. MRA ediciones ESRA-España; 2003. Vol. VI. pp. 367-379.

  13. Quiroga BC, Altermatt CF. Impacto de la anestesia regional periférica en cirugía ambulatoria. Rev Chil Anest 2011;40:214-223.

  14. Barash PG, Cullen BF, Stoelting R. Local anesthetics. In: Barash PG, Cullen BF, Stoelting RK. Handbook of clinical anesthesia. Philadelfia: JB Lippincott; 1993. pp. 203–18.

  15. García de Lorenzo A, Longarela A, Olarra J, Suarez L, Rodríguez MJ. Hiperglucemia postagresión quirúrgica. Fisiopatología y prevención. Cirugía Española 2004; 75 (4): 167-170.

  16. Bonica JJ. Postoperative pain. In: Bonica JJ, ed. The management of pain. Malvern: Lea & Febirger;1990. pp. 461-480.

  17. Beauregard L, Pomp A, Choiniere M. Severity and impact of pain after day-surgery. Can J Anaesth 1998;45:304-311.

  18. Ramírez GM, Schlufter SR. Bloqueo ciático-femoral tres en uno. Revisión de un año. Rev Mex de Anestesiología 2010;33:79-87.

  19. Ferrer GC, Puig BR, Boada PS, Recasens ÚJ, Rull BM. Analgesia postoperatoria en la intervención abierta de hallux valgus en CMA. Comparación entre analgesia oral y bloqueo perineural continuo del nervio tibial posterior. Rev Esp Anestesiol Reanim 2006;53:220-225.

  20. Bloqueos perineurales continuos para analgesia postoperatoria en régimen ambulatorio. Rev Esp Anestesiol Reanim 2006;53:205-207.

  21. Ilfeld B, Enneking K. Ambulatory perineural local anesthetic infusion. Reg Anesth 2003;7:48-54.

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

  23. Oliveira RV, Almeida CR, Da Silva MB, Rodríguez AR, Araújo RR, TSA, Martins FN. Bloqueo de los nervios tibial y fibular común en fosa poplítea con punción única utilizando el estimulador percutáneo de nervios: consideraciones anatómicas y descripción ultrasonográfica. Rev Bras Anestesiol 2011;61:5:293-298.

  24. Chin KJ, Wong NW, Macfarlane AJ, Chan VW. Ultrasound-guided versus anatomic landmark-guided ankle block: A 6-year retrospective review. Reg Anesth Pain Med 2011;36:611-18.




2020     |     www.medigraphic.com