Samuel Rohit, Sloan Andrew, Patel Kuntal, Aglan Magdy, Zubairy Aamir
J Bone Joint Surg Am. 2008 Jul;90(7):1443-6. doi: 10.2106/JBJS.G.01133.
Postoperative pain following forefoot surgery can be difficult to control with oral analgesia. The aim of this study was to compare the efficacy of a combined popliteal and ankle block with that of an ankle block alone in providing postoperative analgesia following forefoot surgery.
We performed a prospective, randomized, controlled single-blind study involving sixty-three patients, twenty-six of whom had a combined ankle and popliteal block and thirty-seven of whom had an ankle block alone. All patients underwent an elective osseous surgical procedure on the forefoot. Postoperative pain was evaluated with use of a visual analogue scale and a verbal response form. Patient satisfaction was also recorded.
The patients who had had a combined popliteal and ankle block had significantly less pain at six hours postoperatively (p = 0.011), twenty-four hours postoperatively (p < 0.001), and at discharge (p = 0.014). This group of patients also had higher satisfaction with pain relief.
A popliteal block in conjunction with an ankle block provides significantly better pain relief than does an ankle block alone in patients undergoing forefoot surgery.
前足手术后的疼痛难以通过口服镇痛药控制。本研究的目的是比较腘窝阻滞联合踝关节阻滞与单纯踝关节阻滞在前足手术后提供术后镇痛的效果。
我们进行了一项前瞻性、随机、对照单盲研究，纳入63例患者，其中26例接受了踝关节和腘窝联合阻滞，37例仅接受了踝关节阻滞。所有患者均接受了前足择期骨性手术。术后疼痛采用视觉模拟量表和言语反应表进行评估。还记录了患者满意度。
接受腘窝阻滞联合踝关节阻滞的患者在术后6小时（p = 0.011）、术后24小时（p < 0.001）和出院时（p = 0.014）疼痛明显减轻。该组患者对疼痛缓解的满意度也更高。
对于接受前足手术的患者，腘窝阻滞联合踝关节阻滞比单纯踝关节阻滞能提供明显更好的疼痛缓解。
