Abstract
Objective: The purpose of the current study was to assess the success rate of posterior tibial nerve block in the ankle with and without ultrasound guidance for pain management in emergency departments. Methods: This clinical trial was conducted on 80 individuals who needed posterior tibial nerve block in the ankle at the emergency department of Hashemi Nejad hospital and Edalatian emergency center in Mashhad, Iran. The eligible individuals were randomly assigned to one of two groups, designated the control (landmark-based nerve block) and the case group (ultrasound-guided nerve block). The two groups were compared in terms of the main measurable outcomes. The data were analyzed using SPSS software (version 20) by nonparametric tests. Results: According to the findings, the mean and median of nerve block success in the landmark-based and ultrasound-guided methods were significantly different between the two groups, both 15 (P=0.02) and 30 (P=0.001) min post-intervention. In this regard, nerve block with ultrasound guidance had a higher success rate compared to the landmark method. However, no significant difference between the two interventions was found in terms of the mean and median of the procedure duration (P=0.8) and injection frequency (P=0.4). On the other hand, the two groups were significantly different regarding the median and mean of patient satisfaction (P=0.00), duration of analgesia (P=0.004), and nerve block-related complications (P=0.03). Conclusion: The findings revealed that the relatively new technique of nerve block by ultrasound-guide resulted in better outcomes than the landmark-based method. Consequently, this method could be adopted to control acute pain in the emergency departments and improve patient care.
Highlights
Pain is an unpleasant experience that occurs due to potential tissue damage
The results of the statistical test demonstrated no significant difference between the males and females in the control group in terms of the mean of blocking success (P = 0.2)
Blocking success showed no significant difference between the males and females in this group (P = 0.1)
Summary
Pain is an unpleasant experience that occurs due to potential tissue damage. Since the goal of medical science is to maintain and improve health and reduce suffering, effective pain relief is a matter of fundamental importance [1]. This leads to a considerable loss of time, and causes pain and possible complications in patients [5] and cannot reliably prevent intraneural injection [6] Blocking through these methods will be much more difficult in cases with disturbed local anatomy (e.g., history of surgery, radiotherapy, mass, obesity, and muscle hypertrophy) [7]. Given the fact that all investigations reviewed in the mentioned study had a small sample size and were in the form of case reports, the authors recommended to perform further research, especially randomized controlled trials, to obtain more accurate findings Bearing this in mind, the present study was conducted to compare the success rate of posterior tibial block in the ankle with and without ultrasound guidance for pain management in the emergency departments
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