Spinal Anesthesia Versus Popliteal and Adductor Canal Blocks for Ambulation After Pott's Fracture Surgery

Abstract

Peripheral nerve blocks (PNBs) have been extensively used in patients with poly-trauma posted for emergency surgeries and for patients with critical co-morbidities who cannot tolerate even the slightest alteration of hemodynamic status. Recently several developments have led to an increased interest in lower extremity PNBs, including recognition of transient neurological symptoms associated with spinal anesthesia and evidence of improved rehabilitation outcome with lower limb PNBs. Complications to spinal and epidural anesthesia also include hypotension due to the vasodilatory effect of the sympathetic blockade, in addition to the rare but potentially serious risk of compressive neuraxial hematoma (Pitkänen et al., 2013). It is desirable to provide effective anesthesia, rapid and an uneventful recovery, persistent postoperative analgesia and early ambulation to patients. Also they are ideally suited for lower limb surgeries because of the peripheral location of the surgical site and the potential to block pain pathways at multiple levels (Palkhiwala and Bhatt, 2015). With the development of ultrasonographic imaging and neurostimulation technology, more and more anesthesiolo¬gists