Multi-modal-analgesia for pain management after Hallux Valgus surgery: a prospective randomised study on the effect of ankle block

Turan, İbrahim; Assareh, Hamid; Rolf, Christer; Jakobsson, Jan

doi:10.1186/1749-799x-2-26

Cited by 25 publications

(43 citation statements)

References 15 publications

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“…18 Bupivacaine ankle block can reduce the need for rescue analgesia compared to the lidocaine block. 38 Postoperative pain can be amplified by central neuroplasticity due to operative nociception. 10 Preemptive analgesia is an antinociceptive treatment that prevents establishment of altered central processing of afferent input from the site of injury/surgery.…”

Section: Discussionmentioning

confidence: 99%

Postoperative Pain and Preemptive Local Anesthetic Infiltration in Hallux Valgus Surgery

Gądek¹,

Liszka²,

Wordliczek

2014

Foot Ankle Int.

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Section: Discussionmentioning

confidence: 99%

Postoperative Pain and Preemptive Local Anesthetic Infiltration in Hallux Valgus Surgery

Gądek¹,

Liszka²,

Wordliczek

2014

Foot Ankle Int.

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“…In HV correction surgery however, surgeons may be bothered by the edema of soft tissues around the surgical site after preoperative peri‐incisional LA infiltration that might disturb recognition of anatomic structures. In addition, peri‐incisional LA infiltration alone showed less analgesic effect than combined ankle nerve blocks with LA infiltration due to peri‐incisional LA infiltration not being able to anesthetize the medial first metatarsal bone that is innervated by deep peroneal and medial plantar nerves. It elucidates that the lesser analgesic effect of LA administration as compared with ankle blocking in this study might be due to the lack of blockade of the deep layer nerve distributions on periosteum.…”

Section: Discussionmentioning

confidence: 99%

“…The tibial nerve innervates the volar aspect of foot, and there are many sites capable of blocking it. It can be blocked by using a classic or sustentaculum tali approach via injection of LA below the medial malleolus or just anatomically posterior to the medial malleolus parallel to posterior tibial artery . However, via using ultrasound guidance to assist peripheral nerve blockade, the technique became more successful than traditional landmark or nerve stimulation and the block needle is able to penetrate the flexor hallucis longus muscle above the tip of medial malleolus without palpation of artery pulsation .…”

Section: Discussionmentioning

confidence: 99%

Pretreatment of ankle nerve block provides better postoperative analgesia than peri‐incisional local anesthetic infiltration in hallux valgus correction surgery

Huang

Tseng

et al. 2019

The Kaohsiung J of Med Scie

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Adequate postoperative analgesia after hallux valgus (HV) correction surgery improves early mobilization and decreases hospital stay. Peripheral nerve block and peri‐incisional local anesthetic (LA) infiltration are both widely used for pain management in orthopedic surgeries. The aim of this study was to compare the analgesic effects between the ankle block and peri‐incisional infiltration technique in patients undergoing HV correction surgery. Ninety patients scheduled for hallux valgus correction surgery were randomly allocated into three groups. In group N, patients were pretreated with tibial and peroneal nerve blocks with 8‐10 mL of 0.25% bupivacaine before surgery. In group P, patients received the same LA for peri‐incisional infiltration preoperatively. In group C, patients underwent surgery without regional analgesic pretreatment. All patients had intravenous fentanyl patient control analgesia as part of multimodal postoperative pain management. Fentanyl consumption, rest and moving pain scale, and adverse effects were evaluated at postoperative 6 h (Poh6), Poh12, Poh 24, and Poh36, respectively. Patients receiving bilateral feet surgeries were excluded in this study. Seventy‐five patients were enrolled into final analysis. The patients in group N expressed lower resting and moving pain scores at Poh6, but the pain scores turned similarly among the three groups following Poh12 and then. The total fentanyl consumption was significantly less in group N than in group P. The postoperative activities and mood disturbance were not significantly different between groups after Poh12 and then. We conclude that ankle block is better than peri‐incisional LA infiltration in HV correction surgery in pain relief and fentanyl consumption.

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“…In their prospective study of 71 cases, Russell et al [2] reported that ankle block markedly decreased the postoperative 24-h VAS score and that it is a safe method. On the contrary, Turan et al [15] performed preincisional local lidocaine with general anesthesia in 90 cases and found no effect of adjuvant ankle block on acute surgical pain. In their study, etoricoxib and paracetamol were administered as the standard analgesic treatment, and no difference was detected between the groups.…”

Section: Discussionmentioning

confidence: 99%

“…The aim was only to assess the efficacy of ankle block as an adjuvant to general anesthesia. Turan et al [15] found that the ankle block group had markedly lower 24-h VAS scores. Paracetamol and tramadol were used for the postoperative analgesic regimen.…”

Section: Discussionmentioning

confidence: 99%

Ankle Nerve Block Adjuvant to General Anesthesia Reduces Postsurgical Pain and Improves Functional Outcomes in Hallux Valgus Surgery

Kır

Kir

2018

Med Princ Pract

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Objective: Postoperative pain is a frequent problem after orthopedic procedures like hallux valgus surgery. The aim of this study was to evaluate whether ankle block improves early and mid-term functional outcomes and postoperative pain management after hallux valgus surgery in patients receiving general anesthesia. Subjects and Methods: This randomized controlled trial investigated 60 patients who underwent hallux valgus surgery under general anesthesia. Patients were prospectively randomized into 2 groups: general anesthesia only (group A) and ankle block added to general anesthesia (group B). Age, body-mass index, tourniquet time, duration of surgery, first analgesic need time, perioperative analgesic regimen, visual analog scale (VAS), American Orthopedic Foot and Ankle Score (AOFAS), and length of hospital stay were recorded. Independent variables were analyzed by t test. Nonparametric data were analyzed by the Mann-Whitney U test. Results: Patient age, demographics, and body mass indices were similar between the 2 groups. The average length of hospital stay was significantly longer in group A (p < 0.01). Group B had a longer time to first analgesic need than group A (p < 0.01). Patients in group B required less analgesic during the postoperative period. Preoperative VAS and AOFAS scores were not statistically dif ferent between the 2 groups. The postoperative day 1 VAS score was significantly lower in group B than in group A. Follow-up visits at 3, 6, and 12 months showed significantly lower VAS and higher AOFAS scores in group B than group A. Conclusion: Ankle block added to general anesthesia may improve early and mid-term postoperative functional outcomes and postoperative pain management in patients who undergo hallux valgus surgery.

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Multi-modal-analgesia for pain management after Hallux Valgus surgery: a prospective randomised study on the effect of ankle block

Cited by 25 publications

References 15 publications

Postoperative Pain and Preemptive Local Anesthetic Infiltration in Hallux Valgus Surgery

Postoperative Pain and Preemptive Local Anesthetic Infiltration in Hallux Valgus Surgery

Pretreatment of ankle nerve block provides better postoperative analgesia than peri‐incisional local anesthetic infiltration in hallux valgus correction surgery

Ankle Nerve Block Adjuvant to General Anesthesia Reduces Postsurgical Pain and Improves Functional Outcomes in Hallux Valgus Surgery

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