CLINICAL TRIAL article
Front. Med.
Sec. Intensive Care Medicine and Anesthesiology
Liposomal Bupivacaine for Popliteal Sciatic and Saphenous Nerve Blocks in Patients Undergoing Foot and Ankle Surgery: A Single-Center, Double-Blind, Randomized Controlled Trial
Jun Wang
Yan Yang
Fu-Qiang Chen
Kang Wang
Xue-Cheng Meng
Jian Zheng
Xuzhou Renci Hospital, Jiangsu, China
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Abstract
Background: Patients undergoing foot and ankle surgery often experience severe postoperative pain. This study aimed to assess the efficacy of liposomal bupivacaine for popliteal sciatic and saphenous nerve blocks in managing pain after foot and ankle surgery. Methods: The study was registered with the Chinese Clinical Trial Registry (ChiCTR2400088305) and received ethical approval from the Institutional Review Board of Xuzhou Renci Hospital (XZRCLL-KT-202407003). In this randomized trial, 142 patients undergoing elective foot/ankle surgery received popliteal-sciatic and saphenous nerve blocks with either 50 mg ropivacaine (R group) or 133 mg liposomal bupivacaine (L group). Primary outcome was postoperative sufentanil consumption; secondary outcomes included analgesia duration, motor blockade, recovery quality, sleep quality, and adverse events. Results: Compared with Group R, Group L demonstrated significantly lower sufentanil consumption at 12 h, 24 h, 48 h, and 72 h postoperatively (all P < 0.001). The L group exhibited significantly higher sleep quality (P < 0.001) and quality of recovery (P < 0.001) on postoperative day 1. Multivariable logistic regression analysis identified surgical type, preoperative sleep quality, and Pain Catastrophizing Scale scores as independent predictors of postoperative pain trajectory. Conclusions: The administration of liposomal bupivacaine for popliteal sciatic and saphenous nerve blocks significantly reduces postoperative opioid consumption and extends nerve block duration, providing a safe and effective technique for postoperative analgesia in patients undergoing foot and ankle surgery. Preoperative sleep quality, surgical type, and Pain Catastrophizing Scale score are independent predictors of the pain trajectory that can identify patients more likely to benefit from liposomal bupivacaine.
Summary
Keywords
Foot and ankle surgery, Liposomal Bupivacaine, long-acting analgesia, Popliteal sciatic nerve block, saphenous nerve block
Received
24 November 2025
Accepted
19 February 2026
Copyright
© 2026 Wang, Yang, Chen, Wang, Meng and Zheng. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
*Correspondence: Jian Zheng
Disclaimer
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