Overview
The study aim is to evaluate the efficacy of the gastrocnemius plane block (GPB) in providing postoperative analgesia for patients undergoing foot and ankle surgery.
- Objectives
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- To evaluate the duration of postoperative analgesia provided by the gastrocnemius plane block
- To assess postoperative opioid or rescue analgesic consumption within the first 24 hours after surgery
- To measure postoperative pain intensity at predefined time intervals using a validated pain scale (e.g., VAS).
- To assess the incidence of block-related complications, including motor weakness, vascular puncture, nerve injury, or local anesthetic systemic toxicity We hypothesize that GPB will result in lower postoperative pain scores and reduce opioid/rescue analgesic consumption compared with standard analgesic management after foot and ankle surgery.
Eligibility
Inclusion Criteria:
- Elective foot and ankle surgeries, including procedures for fractures of the fibula, tibia-fibula, metatarsal, or calcaneus, as well as corrective surgery for hallux valgus;
- Aged 18- 65 years
- BMI 18-28 kg/m2
- ASA Ⅰ-Ⅲ.
Exclusion Criteria:
- Puncture site infection
- Abnormal coagulation function: international normalized ratio (INR) \> 1.5; platelet count \< 50×109/L
- Local anaesthesia allergy
- Unstable coronary syndrome (e.g., recent myocardial infarction within 3 months);
- Severe cardiopulmonary disease: heart failure (NYHA, functional class III or IV)
- Severe pulmonary disease (e.g., chronic obstructive pulmonary disease with FEV1 \< 50% of predicted, or requiring home oxygen therapy)
- Liver insufficiency: liver disease (Child- Pugh class B or C) or elevated liver enzymes (ALT or AST) \> 3 times the upper limit of normal;
- Renal insufficiency renal impairment (estimated glomerular filtration rate, eGFR\<30 mL/min/1.73m2) or requiring renal replacement therapy
- Long-term preoperative use of sedative and analgesic drugs;
- Communication disorders
- History of chronic pain.
- Operative time \> 3 h.
