1 Foot and Ankle Surgery Group, Orthopedics and Traumatology Department, Hospital do Servidor Público Estadual, São Paulo, São Paulo (SP), Brazil.
Foot Ankle Int. 2018 Feb;39(2):196-200. doi: 10.1177/1071100717739670. Epub 2017 Nov 21.
Anesthetic block of the peripheral nerves in the foot and ankle is generally used as anesthesia. The increased use of anesthetic blocks has made this technique an increasingly safe method, and its use has been expanded to postoperative analgesia in foot and ankle surgeries. The objective of this study was to evaluate the analgesia time and pain intensity, using objective scores, after peripheral nerve block in foot and ankle surgeries.
Patients who underwent surgery by the foot and ankle group of our institution from March 2016 to January 2017 were invited to participate in this prospective, randomized, and blinded study after signing an informed consent form. The study was approved by the local ethics committee. In total, 57 patients and 59 feet (2 bilateral surgeries) were subjected to spinal anesthesia and were randomized into the group receiving peripheral nerve block in the foot and ankle (7.5 mg/mL ropivacaine) and the control group. The patients answered a questionnaire, administered by phone during the postoperative period, regarding measurement of pain intensity, using the visual analog scale (VAS), and the time of onset of pain.
Improved pain was noted in patients who received a supplemental peripheral nerve block in relation to the duration of postoperative analgesia and the intensity of pain during the immediate postoperative period. No significant difference was found between the 2 groups in terms of pain intensity on the first or second postoperative day.
Peripheral nerve block in the foot and ankle region can be used effectively as postoperative analgesia to reduce pain intensity during the immediate postoperative period and prolong analgesia.
Level I, high-quality prospective randomized clinical trial.
足部和踝关节周围神经的麻醉阻滞通常用作麻醉。随着麻醉阻滞使用的增加，这种技术已成为一种越来越安全的方法，其应用范围已扩大到足部和踝关节手术的术后镇痛。本研究的目的是使用客观评分评估足部和踝关节手术后周围神经阻滞的镇痛时间和疼痛强度。
在签署知情同意书后，邀请 2016 年 3 月至 2017 年 1 月期间在我们机构接受足部和踝关节手术的患者参与这项前瞻性、随机、双盲研究。该研究得到了当地伦理委员会的批准。共有 57 名患者和 59 只脚（2 例双侧手术）接受了脊髓麻醉，并随机分为接受足部和踝关节周围神经阻滞（7.5mg/mL 罗哌卡因）的组和对照组。术后，患者通过电话回答问卷，评估疼痛强度，使用视觉模拟评分法（VAS）和疼痛出现时间。
与术后镇痛持续时间和即刻术后期间疼痛强度相比，接受补充外周神经阻滞的患者疼痛明显改善。两组患者在术后第 1 天或第 2 天的疼痛强度方面无显著差异。
足部和踝关节区域的外周神经阻滞可有效用作术后镇痛，以减轻即刻术后期间的疼痛强度并延长镇痛时间。
I 级，高质量前瞻性随机临床试验。
