Publication:

Ultrasound-guided popliteal block for foot and ankle surgery: a prospective observational study of clinical outcomes and patient satisfaction

Background Regional anaesthesia has become an integral component of modern perioperative care owing to its ability to provide superior postoperative analgesia while reducing opioid consumption and avoiding the physiological perturbations associated with general anaesthesia. Ultrasound-guided popliteal block has emerged as an effective technique for surgeries involving the foot and ankle, offering precise localisation of neural structures and improved procedural success. However, clinical data evaluating its effectiveness in the Indian population remain limited. Aim was to evaluate the clinical efficacy, safety, block characteristics, postoperative analgesia, and patient satisfaction associated with ultrasound-guided popliteal block as the primary anaesthetic technique for foot and ankle surgery.

Methods A prospective observational study was conducted in 60 adult patients (ASA physical status I to III) undergoing elective or emergency foot and ankle surgery. Ultrasound-guided popliteal sciatic nerve block was performed using a mixture of 10 ml of 1.5% lignocaine and 5 ml of 0.5% bupivacaine. Procedural time, onset and duration of sensory and motor blockade, duration of postoperative analgesia, haemodynamic variables, block success, complications, and patient satisfaction were recorded and analysed.

Results The mean procedure time was 4.1±1.3 minutes. Sensory blockade occurred after 3.1±1.0 minutes, while motor blockade developed after 7.0±1.3 minutes. Mean duration of sensory blockade was 183±14.8 minutes and motor blockade lasted 144.3±13.3 minutes. The first postoperative complaint of pain occurred after 239.0±21.6 minutes. Haemodynamic parameters remained stable throughout the perioperative period. Only one block required conversion to general anaesthesia, resulting in an overall success rate of 96.7%. No procedure-related complications were observed, and all remaining patients reported high satisfaction with the anaesthetic technique.

Conclusions Ultrasound-guided popliteal sciatic nerve block is a safe, reliable, and effective primary anaesthetic technique for foot and ankle surgery. It provides rapid onset, prolonged postoperative analgesia, excellent patient satisfaction, and minimal complications. Wider adoption of this technique may contribute to enhanced recovery protocols and reduced perioperative opioid requirements.