Abstract
Objective: To analyze the effectiveness of peripheral nerve blocks in the ankle in percutaneous forefoot surgery and their potential complications. Methods: Retrospective study with a survey of the medical records of patients who underwent percutaneous orthopedic surgery onthe forefoot between 2009 and 2015, performed by the orthopedic foot and ankle surgery group of our hospital, in which 4-in-1 and 5-in-1 anesthetic nerve blocks were used. We evaluated 239 cases, consisting of 222 female and 17 male subjects with a mean age of 61.2 years, seeking to observe the effectiveness and potential complications of the anesthetic technique. Results: Complications were observed in 3.34% of the 239 patients, with seven cases of neuritis and one case of tachycardia. Regarding the anesthetic technique, there were nine cases of block failure (3.76%), with four cases requiring supplementary local anesthetic, one case spinal anesthesia, and four cases general anesthesia. Conclusion: Having observed the low rate of complications and the almost complete success of 5-in-1 blocks in percutaneous forefoot surgery, we concluded that it is a safe and effective anesthetic technique. Level of Evidence IV, Therapeutic Study; Case Series.
Highlights
In forefoot deformities, which can be corrected by percutaneous techniques, when surgical treatment is indicated, it is imperative to plan the surgical intervention carefully
The aim of this study was to analyze the effectiveness of peripheral nerve blocks in the ankle when performing percutaneous forefoot surgery and their potential complications
The anesthesia was effective in 96.26% of the blocks, enabling us to perform the proposed surgical procedures
Summary
In forefoot deformities, which can be corrected by percutaneous techniques, when surgical treatment is indicated, it is imperative to plan the surgical intervention carefully. Small volumes of local anesthetics in perineural regions promote analgesia and anesthesia over an extensive area, corresponding to the cutaneous topography of the nerve.[2] When applied to orthopedic forefoot surgery, they are of practical interest, as they are relatively safe and easy to perform, when specific standards are followed. This technique avoids spinal and general anesthesia and has a lower operative and postoperative risk, especially in elderly patients or individuals with comorbidities[3].
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