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Ankle Block for Foot Surgery

Nearly all mid and forefoot surgery can be comfortably and reliably performed using local anaesthesia (ankle block).

The benefits associated with using this technique include avoidance of a general anaesthetic with its associated side effects such as drowsiness, nausea and vomiting.

Orthopaedic Foot and Ankle Surgeon, Dr George Dracopoulos and Anaesthetist, Dr Glenda Rudkin have recently completed a six year study of 1000 patients having surgery performed using this technique. *

Results of this study have shown many benefits in addition to the avoidance of a general anaesthetic.These include high patient satisfaction, the opportunity for patient interaction during the surgery and excellent post-operative pain relief.

Dr Dracopoulos now performs most mid and forefoot surgery using ankle block.

WHAT TO EXPECT

Following admission to hospital, the anaesthetist will see the patient and discuss any aspects relating to anaesthesia and the choice of having an ankle block as opposed to a general anaesthetic.

If the decision is made to have local anaesthesia (ankle block) then you will be taken to an area adjacent to the operating theatre where the anaesthetist will insert a needle into the back of your hand through which calming medication (sedation) can be given.

The ankle block consists of several injections of local anaesthetic around the ankle. Most patients do not have a recollection of this due to the sedative drugs which are used at this time.

You will be left to wait a short time in this area so that the local anaesthetic can take effect. Once the anaesthetist has ensured that the foot is appropriately numb you will be then taken to the operating theatre.

Once in theatre, the leg will be elevated and a tourniquet will be applied just above the ankle as shown below.

Your lower leg and foot will be painted with antiseptic. The tourniquet will usually be inflated before any incision is made. The patient will feel a tightness around the ankle but our study has shown that 97% of patients find this tolerable.

During surgery you can choose to be fully awake or mildly to heavily sedated. Your anaesthetist will closely monitor your progress and assess your need for any further sedation. Should you choose to remain fully awake you will be able to listen to music through headphones.

If desired you will also be able to periodically observe what is happening with your surgery. This is up to you the patient.



Above: A patient comfortably observes surgery during bony correction.

Once surgery is completed you will be taken to the recovery area for monitoring before returning either to the day surgery unit or to your room.

A major benefit of an ankle block is the fact that it provides pain relief after the surgery for approximately twelve hours. Your anaesthetist will provide post operative medication for pain relief once the block wears off.

Any questions regarding the choice of anaesthesia for your surgery may be directed to Dr. Dracopoulos on 8267 8211.

*Acceptability of ankle tourniquet use in midfoot and forefoot surgery: an audit of 1000 cases.

Rudkin GE, Rudkin AK, Dracopoulos GC

Published in:

Foot and Ankle International

2004 November; 25 (11); 788-94

 

This material has been produced as a reference guide only and should not be used in place of a consultation with a qualified medical practitioner.