Comparison of popliteal approach sciatic nerve block and tibial-common peroneal nerve block in patients undergoing unilateral foot and ankle surgery: a prospective randomized controlled clinical study

Aims: The aim of this study is to compare the perioperative effects of Tibial Common Peroneal Nerve Block (TCPNB) and Sciatic Nerve Block (SNB) with popliteal approach in patients undergoing unilateral foot and ankle surgery. Methods: This prospective, single-center study conducted between August 2021 and August 2022, 84 patients undergoing foot and ankle surgery were included and randomized. 11 patients were excluded for various reasons and the patients were divided into two groups, Group Tibial Common Peroneal Nerve Block (Group T) (n=36) and Group Sciatic Nerve Block (Group S) (n=36). For Group T, the tibial and common peroneal nerves were visualized and blocked separately. For Group S, the sciatic nerve in the popliteal fossa was visualized and blocked. Block imaging time, block procedure time, anesthesia onset time, block performance time, and number of needle insertions for the block were recorded. Postoperative (PO) visual analog scale (VAS) scores, PO analgesic consumption and patient satisfaction were also recorded. Results: Group T had statistically significantly longer block imaging and block procedure time (p<0.01) and statistically significantly shorter anesthesia onset time (p<0.01). Group T was statistically significantly longer (p<0.01) when block performance time and PO first analgesic requirement time were compared (19±2.4,13.8±3.2). When the PO VAS scores of the groups were analyzed, Group T had statistically significantly lower VAS scores at 1, 6, 12 and 24 hours except for the post operative care unit (PACU) VAS score. The number of needle insertions was statistically significantly higher in Group T (p<0.001). Block success, complications, postoperative nausea and vomiting and additional anesthetic requirement were similar in the groups. Conclusion: Preferring TCPNB in foot and ankle surgery is not only successful in the time of anesthesia initiation; It also has positive effects in terms of block performance time, PO analgesic effectiveness and efficient use of resources.