Peripheral or central nerve blocks for foot surgery: A prospective, randomized clinical comparison

A. Casati, C. Grispigni, G. Aldegheri, F. Vinciguerra, A. Sciascia, G. Fraschini, G. Fanelli

Research output: Contribution to journalArticlepeer-review


The efficacy of surgical anaesthesia and postoperative analgesia after elective orthopaedic foot surgery was evaluated in 200 healthy patients, randomly allocated to receive either a bilateral spinal anaesthesia (group BSA, n = 50), a unilateral spinal anaesthesia (group USA, n = 50), or a combined sciatic-femoral nerve block performed with 2% mepivacaine (group SFM, n = 50) or 0.75% ropivacaine (group SFR, n = 50). Similar duration of surgery was reported in the four groups (median 50 min, range 20-90 min), without differences in times of thigh tourniquet. Surgeon satisfaction was 92% in group SFM and 90% in group SFR, 94% in group BSA and 94% in group USA (P = 0.18). Tourniquet pain during surgery was reported in two SFM patients and three SFR patients, while two patients in each group required anaesthetic implementation. No urinary retention was reported in SFM and SFR groups, but seven BSA patients (14%) and one USA patient (2%) required bladder catheterization (P = 0.005). Postoperative analgesia was longer in group SFR (13.4 h) than in the SFM (4.6 h), BSA (3.1 h), and USA (3.2 h) groups (P = 0.0005), with reduced analgesic consumption (P = 0.0005). When providing anaesthesia for foot and ankle procedures, the combination of sciatic and femoral nerve blocks is as effective and safe as spinal anaesthesia with less urinary retention. Longer postoperative analgesia is provided by ropivacaine than mepivacaine.

Original languageEnglish
Pages (from-to)95-100
Number of pages6
JournalFoot and Ankle Surgery
Issue number2
Publication statusPublished - 2002


  • Local anaesthesia
  • Orthopaedic surgery
  • Sciatic-femoral nerve block
  • Spinal anaesthesia

ASJC Scopus subject areas

  • Orthopedics and Sports Medicine


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