Analgesia postoperatoria en la cirugía del pie y tobillo mediante bloqueo ciático poplíteo lateral con ropivacaína

摘要

Introduction: Popliteal sciatic nerve block provides efficacy and prolonged postoperative analgesia after foot and ankle surgery. The most important advantage of lateral approach is that it is not necessary to modify supine patient position, but posterior approach needs prone position of patient. It could be difficult in some situations: pregnancy, inestability haemodynamic and mechanical ventilation. Material and method: Physical status I-II patients, presented for foot and ankle surgery were included. A blockade of sciatic nerve at popliteal fossa level was realized using Vloka and Hadzic references with a 22G x 80 mm insulated needle. An adecuate motor response was considered when a foot movement was obseved at a stimulation intensity lower than 0.4 mA and higger than 0.1 mA. The dose of local anaesthetic administered was 0.5% ropivacaine, 40 ml. We registered postoperative repose and movement pain at 8, 16 and 24 hours after the blockade using VAS form 0 to 10 and patient satisfaction from 0 to 10, too. Results: Twenty-one ASA I-II patients were included. The medium repose postoperative pain registered was 1 at 8 hours and 3 at 16 and 24 hours after blockade. The medium movement postoperative pain registered was 2 at 8 hours and 4 at 16 and 24 hours after the blockade. The medium satisfaction of patient was 9. Discussion: Lateral approach to popliteal sciatic nerve did not need to modify supine patient position. It provided excellent analgesia both repose foot and movement foot. In conclussion, lateral approach to sciatic nerve at popliteal fossa with 0.5% ropivacaine, 40 ml provided useful postoperative analgesia without undesirable effect and high satisfaction of patient after foot and ankle surgery.