The use of lower extremity nerve blocks in children at the lower tibia for prolonged analgesia after foot corrective surgery

Abstract

Introduction The use of lower extremity nerve blocks at the lower tibia was reviewed in children with congenital and acquired pathology to provide prolonged analgesia after a foot corrective surgery. Material and methods The study included 49 patients with congenital malformations (congenital clubfoot, flat and valgus foot, vertical talus, longitudinal ectromelia) who underwent corrective surgical procedures. Patients were divided into 2 groups. Sedation, drug-induced sleep, spinal anesthesia, regional anesthesia at the lower third of tibia were produced for the patients of index group. Control group had sedation, drug-induced sleep and spinal anesthesia. The Face, Legs, Activity, Cry, Consolability scale (FLACC) was used to assess pain in the children. In addition to that, a dose of opioid pain relievers (Tramadol) administered on the first postoperative day and satisfaction with anesthesia and analgesia were also considered. Results Index group showed longer-term FLACC scores at a low level with less consumption of narcotic and sedating drugs. No complications were observed with regional anesthesia of the foot. Conclusion Lower extremity peripheral nerve blockade at the lower third of tibia has shown to provide efficient postoperative analgesia in surgical correction of pediatric foot deformities.