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
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.
- Disclosure: Singh has no relevant financial disclosures.
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