A Prospective Comparison of Ultrasound-Guided Ankle Versus Popliteal Nerve Blocks for Elective Forefoot Surgery in a UK Podiatric Surgery Unit
Abstract
Background: Regional anaesthesia is central to perioperative care in foot surgery, yet comparative data within UK podiatric surgery services remain limited. Establishing local outcome baselines is essential for optimising care and supporting clinical scope.
Aim: To compare pain intensity levels and functional recovery in patients undergoing elective forefoot surgery under ultrasound-guided ankle or popliteal nerve block.
Methods: This prospective service evaluation involved 17 adults undergoing elective forefoot surgery. Participants were allocated via pragmatic, nonrandomised sequential scheduling based on surgeon preference to receive either an ultrasound-guided ankle block (n = 9) or popliteal nerve block (n = 8) using 0.5% levobupivacaine. Outcomes included sensory onset time, duration of analgesia, pain intensity (VAS), opioid consumption standardised to morphine milligram equivalents (MME), and functional recovery assessed using a modified Functional Recovery Index (FRI).
Results: Sensory onset times showed no significant difference between groups (p = 0.491). Popliteal blocks provided significantly longer analgesia than ankle blocks (23.75 vs. 12.61 hours; p = 0.038), whereas procedural discomfort was comparable (p = 0.449). Postoperative pain trajectories differed significantly (p = 0.049), with pain decreasing from Day 1 to Day 3 following ankle block but increasing following popliteal block. Opioid consumption declined over time across the cohort (p = 0.015), with…
How strong is the evidence?
Evidence Hub reads this as a clinical trial, done in people. Its evidence level is 3 of 5 (Moderate · trial / cohort / secondary analysis). Trials without a large randomized design, cohorts and secondary analyses give moderate evidence. Reported size: 17 participants or records.
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