Retrospective review of single-shot and continuous popliteal block efficacy for elective foot and ankle surgery

Abstract

Background: Postoperative pain after foot and ankle surgery is commonly managed using popliteal nerve blocks. Continuous popliteal blocks are utilized due to prolonged analgesia, but catheters increase complications that can hinder rehabilitation. The purpose of our study was to compare postoperative pain and patient satisfaction between patients who received continuous and single-shot popliteal blocks in our health system. Methods: Data was collected for all patients who received continuous or single-shot popliteal blocks at a single academic medical center. Patients were divided based on type of block and further stratified by surgical procedure (ORIF vs. arthroscopic ankle) for sub-analysis. Collected data included demographics, surgical procedure, postoperative day 1 (POD1) pain levels, postoperative day 7 (POD7) patient satisfaction levels, and use of an additional saphenous nerve block. Patient satisfaction and pain levels were collected via phone call using a 5-item Likert Response Scale and 0-10 Numeric Pain Rating. POD1 pain scores and POD7 patient satisfaction levels were compared between block types using Student’s t-test and Mann-Whitney U test respectively. These scores were also sub-analyzed based on surgery type using the same tests. Results: There was no significant difference between continuous or single-shot techniques in postoperative pain (1.85 vs 2.19; p = 0.3371) or patient satisfaction (4.943 vs. 4.8; p = 0.2331). Surgery type had no effect on patient-reported pain or satisfaction. Conclusion: POD1 pain and POD7 patient satisfaction are comparable in continuous and single-shot popliteal blocks; therefore, given the increased risk of continuous blocks, providers should consider using single-shot for analgesia after foot and ankle surgery.