Comparison of Ultrasound-guided Popliteal Block with Adductor Canal Block versus Popliteal Block with Saphenous Nerve Block for Below Knee and Ankle Surgeries

Background and Aim: The lower limb blocks are the localized anesthetic technique carried out under ultrasound supervision and are often used to block various nerve branches in the medial part of the leg and ankle. In addition to the sciatic nerve, a saphenous nerve block is recommended if anesthesia of the foot or lower leg throughout its neural distribution is required. The aim is to compare the efficacy of ultrasound-guided popliteal block with a saphenous nerve block and popliteal block with adductor canal block (ACB) for below-knee and ankle surgeries. Materials and Methods: We performed a randomized, double-blind study wherein 60 patients undergoing below-knee and ankle surgeries were allocated into two groups: Group 1 received a popliteal block with an ACB and Group 2 received a popliteal block with a saphenous nerve block. The duration of intraoperative and postoperative analgesic effects between the two groups were compared. Results: The onset of the sensory and motor blockade in Group 1 was faster and statistically significant ( P = 0.0025 and 0.02, respectively). The time of rescue analgesia was delayed in Group 1 and statistically significant ( P = 0.031). The higher mean postoperative Numeric Rating Scale (NRS) was observed in Group 2; the P value of postoperative NRS was 0.000054 < 0.05, statistically significant. Conclusions: Adductor canal with popliteal nerve block provides a longer duration of analgesia, better intraoperative hemodynamics, and decreased need for postoperative rescue analgesia.