Continuous Lateral Sciatic Blocks for Acute Postoperative Pain Management after Major Ankle and Foot Surgery

Abstract

We developed a continuous lateral sciatic nerve infusion technique for postoperative analgesia. Methods: A 10-cm insulated Tuohy needle connected to a nerve stimulator was introduced posteriorly between the biceps femoris and vastus lateralis groove 10 cm cephalad from the tip of the patella. After proper positioning of the insulated needle, a 20-gauge catheter was placed in proximity to the sciatic nerve. Results: Continuous lateral sciatic infusion of 0.2% ropivacaine was associated with a significant reduction of morphine consumption by 29% and 62% during postoperative days one and two, respectively, in patients who underwent open reduction and internal fixation of the ankle. Conclusion: Continuous lateral sciatic infusion of 0.2% ropivacaine represents an alternative for acute postoperative pain control after major ankle and foot surgery.