Background: Postoperative pain following below-knee orthopaedic procedures is commonly managed with neuraxial blocks, which may delay early ambulation. The conventional posterior approach to sciatic nerve block can be challenging in patients with fractures due to positioning difficulties. The anterior approach offers a viable alternative that allows better positioning for nerve block. The Quality of Recovery-15 (QoR-15) questionnaire is a validated tool to assess postoperative recovery. This study aimed to evaluate the effect of ultrasound-guided sciatic nerve block via the anterior approach on the quality of recovery in patients undergoing below-knee orthopaedic surgery.
Materials and Methods: This was a double-blinded randomised controlled trial. Patients in Group A received an ultrasound-guided sciatic nerve block via the anterior approach along with subarachnoid block, while Group B received only subarachnoid block. The QoR-15 questionnaire was administered postoperatively, and scores were recorded. Additional outcomes included time to first analgesic demand, total fentanyl consumption via PCA pump in the first 24 hours, and any post-procedural complications related to the nerve block or fentanyl administration.
Results: The QoR-15 scores were significantly higher in Group A (128.63 ± 2.36; 95% CI: 127.75–129.51) compared to Group B (108.40 ± 2.86; 95% CI: 107.33–109.46), with p < 0>
Conclusion: Preoperative administration of ultrasound-guided sciatic nerve block via the anterior approach significantly improves the quality of recovery in patients undergoing below-knee orthopaedic surgery. It also prolongs the duration of postoperative analgesia and reduces opioid consumption in the early postoperative period.
Keywords: Early ambulation, Postoperative pain, Orthopaedic procedures, Sciatic nerve, Nerve block.
