Peripheral nerve block associated with low postoperative complication rate

TORONTO — Results presented at the American Orthopaedic Foot &Ankle Society Annual Meeting showed use of peripheral nerve block in foot and ankle surgery was associated with a low postoperative complication rate and few serious, unresolved complications.

“The use of the peripheral nerve blocks in foot and ankle surgery is associated with a low postoperative complications rate of 7.2%,” Grace Kunas, BA, said in her presentation here. “Most of the complications are neurological in nature, and the majority of complications are un-attributable to the blocks.”

Kunas and colleagues collected data for surgical time, tourniquet time and demographics among 2,516 patients who underwent 2,704 foot and ankle procedures between October 2012 and October 2014. Surgeons filled out a survey at all postoperative visits for patients detailing the nature and anatomic location of perioperative complications. A surgeon and anesthesiologist unassociated with the cases reviewed all complications and rated these as likely to have occurred from the nerve block, possibly due to the nerve block and definitely not from the nerve block, according to Kunas.

“Out of the 290 complications, 195 of them were possibly related to the block and/or neurologic,” Kunas said.

She noted there were 20 serious complications which were all at least possibly related to the block. Of these, 16 serious complications were unresolved.

“We also found that complications possibly due to the block were significantly higher in those with the popliteal block compared to an ankle block, but there was no difference otherwise in the complications likely due to the nerve block. Interestingly, this significance disappeared when we restricted the procedures to forefoot surgery only,” Kunas said.

Researchers identified dexamethasone as a significant predictor in the complications at least possibly due to the block. – by Casey Tingle

Reference:

Kunas G, et al. A 2-year, prospective, blinded analysis of complications following peripheral nerve blocks in foot and ankle surgery. Presented at: American Orthopaedic Foot & Ankle Society Annual Meeting; July 21-23, 2016; Toronto.

Disclosure: Kunas reports no relevant financial disclosures.