Sciatic nerve blockade improves early postoperative analgesia after open repair of calcaneus fractures

J Orthop Trauma. 2004 Apr;18(4):197-201. doi: 10.1097/00005131-200404000-00001.


Objective: To determine the effectiveness of analgesia, with or without sciatic nerve blockade, after open repair of calcaneus fracture.

Design: Randomized, prospective trial involving 30 patients divided into 3 groups of 10, all having open repair of calcaneus fractures. Group 1 used morphine patient-controlled analgesia alone. Groups 2 and 3 had morphine patient-controlled analgesia and a "one-shot" bupivacaine sciatic nerve blockade, either presurgically (group 2) or postsurgically (group 3).

Setting: Harborview Medical Center operating rooms and orthopedic floors.

Outcome measures: Morphine use over 24 hours, visual analogue scale pain scores, and sciatic nerve blockade duration.

Results: In the absence of sciatic nerve blockade, initial postoperative pain was marked, even with a mean recovery room dose of intravenous morphine more than 30 mg. Sciatic nerve blockade with bupivacaine had a mean duration of 14 hours and substantially reduced pain for the first 24 postoperative hours. Presurgical blockade confers no advantage over postsurgical blockade.

Conclusion: Sciatic nerve blockade confers significant benefit over morphine alone for analgesia after open repair of calcaneus fractures. Postsurgical sciatic nerve blockade provides the longest possible postoperative block duration.

Publication types

  • Clinical Trial
  • Comparative Study
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Analgesia / methods
  • Anesthetics, Local / therapeutic use
  • Bupivacaine / therapeutic use
  • Calcaneus / injuries*
  • Female
  • Fractures, Bone / surgery*
  • Humans
  • Male
  • Middle Aged
  • Nerve Block / methods*
  • Pain Measurement / methods
  • Pain, Postoperative / drug therapy*
  • Prospective Studies
  • Sciatic Nerve*
  • Treatment Outcome


  • Anesthetics, Local
  • Bupivacaine