Efficacy and safety of ankle block versus sciatic–saphenous nerve block for hallux valgus surgery

Background Various nerve block techniques had been used in foot surgery. Objectives The aim of this study was to compare the efficacy of ankle block versus sciatic–saphenous nerve bock for elective hallux valgus surgery. Materials and methods A total of 42 patients who underwent elective hallux valgus surgery under regional anaesthesia were randomized to undergo either ankle block (group I) or combined sciatic–saphenous nerve block (group II). Both blocks were performed using 0.5% bupivacaine mixed with 2% lignocaine. Results Hemodynamic analysis had shown statistically nonsignificant difference between groups I and II. With regard to the duration of postoperative analgesia, there was a statistically nonsignificant difference in the time elapsed before the first analgesic dose between group I (105 min) and group II (88.7 min). However, there was a statistically significant difference in total fentanyl consumption and the need for pethidine injection between group I and group II (P 0.005). Regarding the visual analogue score, there was a statistically significant difference in the visual analogue score between group I (5.5 ± 4.5) and group II (3.5 ± 3.2) in the 12-h postoperative period (P 0.005). Conclusion Combined sciatic–distal saphenous nerve block is as efficient as ankle block with anaesthesia, with no difference in hemodynamics. However, sciatic–saphenous block provides longer postoperative analgesia than ankle block alone and allows the use of thigh tourniquet, thus reducing bleeding and operative time.