Ankle blocks after tourniquet application may provide good foot surgery pain control
Based on the results of their randomized prospective study, orthopaedists at Epsom and St. Helier Hospital in the United Kingdom recommend that ankle blocks be performed after tourniquet application in forefoot reconstructions.
Between September and November 2010, Vinay K. Singh, MBBS, D Orth, MRCS, and colleagues randomized 50 patients into two groups of 25 patients each. The first group underwent forefoot reconstruction surgery with the ankle block used right after tourniquet application, and the second group had the block applied just before tourniquet application.
We conducted a study to see whether timing of ankle block, ie., before or after application of tourniquet, shows any difference in efficacy in postoperative analgesia in the first 24 hours, Singh and colleagues stated in the abstract of their poster. They determined efficacy from results of the Visual Analog Scale pain questionnaires that patients in both groups completed at 4 hours and 24 hours postoperatively.
Both groups demonstrated good postoperative pain control, they stated in the abstract.
However, the average pain scores in the first group with the block done before tourniquet was applied were lower than in the second group 2.5 and 5.0 at 4 hours and 24 hours vs. 3.5 and 6.1 at the same time intervals.
The groups pain scores were not statistically significantly different, however, the investigators noted.
- Singh VK, Bansal A, Sott A. Prospective randomized study of ankle block in forefoot reconstruction Does timing matter? E-poster #28906. Presented at the SICOT XXV Triennial World Congress 2011. Sept. 6-9. Prague.
- Disclosure: Singh has no relevant financial disclosures.