Postoperative Pain and Preemptive Local Anesthetic Infiltration in Hallux Valgus Surgery

Gądek, Artur; Liszka, Henryk; Wordliczek, Jerzy

doi:10.1177/1071100714553790

Cited by 13 publications

(35 citation statements)

References 40 publications

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“…In this study, tibial nerve and deep peroneal nerve were blocked under ultrasound guidance to prevent improper intraneural injections, and the superficial peroneal nerve blockade was undertaken using ultrasound to assist LA administration in subcutaneous tissue; therefore, no patient suffered from nerve injury‐associated symptoms such as numbness, dysesthesia or allodynia along nerve distributions. Furthermore, patients undergoing HV correction surgery using ankle blockade obtained better analgesic effect than using LA infiltration although the infiltrative technique is widely used for postoperative pain relief . 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.…”

Section: Discussionmentioning

confidence: 99%

“…The disturbance of sleep quality and mood changes were also assessed on the coming morning with NRS, which rated from 0 to 10, while the 0 means "the pain totally not disturbed the sleep quality and not changed the mood status" , and 10 means "the sleep quality and mood status was completely affected by the pain". The severities of side effects including itching, nausea, and vomiting were categorized into four grades by NRS as none (0), mild (1-3), moderate (4)(5)(6), and severe (7)(8)(9)(10). Patients were allowed to intake oral medications after being able to tolerate drinking water.…”

Section: Postoperative Carementioning

confidence: 99%

“…Peripheral nerve blockade has been widely used as an anesthetic method or for postoperative analgesia for the advantages of long‐term analgesia and immediate ambulation after surgery . Peri‐incisional local anesthetic (LA) infiltration is also an efficient and safe method to reduce postoperative pain in many orthopedic surgeries . However, the discrepancy of postoperative analgesic effects in patients undergoing HV correction surgery using either peripheral nerve blockade or solely peri‐incisional LA infiltrative administration has still not clarified and assessed thoroughly.…”

Section: Introductionmentioning

confidence: 99%

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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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Section: Discussionmentioning

confidence: 99%

Section: Postoperative Carementioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

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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“…Long-lasting intensive postoperative pain caused by variously surgical procedures, such as hemorrhoidectomy, hallux valgus, total knee arthroplasty, inguinal herniorrhaphy and colectomy, is a key disadvantage factor associated with the functional recovery, healing or cost of hospitalization for patients 1–5. More effective and appropriate control of postsurgical pain is necessary for shortening hospital stays and improving life quality of patients with local surgeries 6–10.…”

Section: Introductionmentioning

confidence: 99%

HYR-PB21-LA, a potential extended-release bupivacaine formulation, produces long-lasting local anesthesia in rats and guinea pigs

Peng

Liu

et al. 2020

Reg Anesth Pain Med

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BackgroundEffective postoperative pain management plays a key role in enhancing recovery of patients after surgery. Bupivacaine hydrochloride is one of the most commonly local anesthetics used for the postoperative pain control. However, the relatively short anesthesia duration of bupivacaine preparations limited their clinical application.MethodsBoth guinea pig pin-prick study and rat tail-flick test were performed to evaluate the local anesthesia efficacy of HYR-PB21-LA, a new microparticle suspension injection of bupivacaine pamoate.ResultsIn the pin-prick test, the complete cutaneous trunci muscle reflex inhibitions were observed at 30 min in all treatment groups containing bupivacaine. In comparison with 6.7 mg/mL HYR-PB21-LA, both 10 and 20 mg/mL HYR-PB21-LA groups had significantly higher area under effect time curve (AUEC) values (p<0.001 and p<0.0001) and slower offset time (p<0.0001). Significantly higher AUEC (p<0.0001) and slower offset time (p<0.0001) were also found in 10 mg/mL HYR-PB21-LA treatment group compared with bupivacaine liposome injectable suspension (liposomal bupivacaine). In the rat tail-flick test, significantly increased local anesthesia effect was lasted for 5 hours after 2.5 mg/mL HYR-PB21-LA administration, which was fivefold longer than bupivacaine hydrochloride. The longer lasted efficacy of significantly increased local anesthesia was also observed in 5 mg/mLHYR-PB21-LA than those in liposomal bupivacaine (8 hour vs 1 hour).ConclusionsThe results demonstrated that the HYR-PB21-LA produced longer local anesthesia effect than current clinical preparations of bupivacaine in two animal models. These findings raise the potential clinical value of HYR-PB21-LA as a long-lasting local anesthesia for controlling postsurgical pain in humans.

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“…Intense pain is common after bunionectomy, 1 particularly in the first few days after surgery. Post-bunionectomy pain is generally classified as a hard-tissue pain model, 2 and its evaluation is useful for assessing the effectiveness of analgesic agents that have a rapid onset of action.…”

Section: Introductionmentioning

confidence: 99%

Evaluation of the safety and efficacy of an intravenous nanocrystal formulation of meloxicam in the management of moderate-to-severe pain after bunionectomy

Gottlieb¹,

Tunick²,

Mack³

et al. 2018

JPR

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ObjectiveThis randomized, double-blind, placebo-controlled study evaluated the safety and efficacy of an intravenous (IV) nanocrystal formulation of meloxicam in subjects with moderate-to-severe pain following a standardized unilateral bunionectomy.MethodsFifty-nine subjects aged 18–72 years were randomized to receive doses of either 30 mg (n=20) or 60 mg (n=20) meloxicam IV or placebo (n=19), administered once daily as bolus IV injections over 15–30 seconds (two or three doses). Safety, the primary objective, was assessed by physical examination, clinical laboratory tests, and the incidence of adverse events (AEs). Efficacy was evaluated by examining summed pain intensity differences over the first 48 hours (SPID48) using analysis of covariance models. Use of opioid rescue analgesic agents was evaluated.ResultsGenerally, AEs were mild-to-moderate in intensity, and their incidence was similar across the three treatment groups. No serious AEs were reported; there were no withdrawals due to AEs, including injection-related AEs. The estimated effect size for SPID48 versus placebo was 1.15 and 1.01 for meloxicam IV doses 30 mg and 60 mg, respectively (P≤0.01). Both doses produced significantly greater pain reductions versus placebo (P≤0.05) at all evaluated times/ intervals during the 48-hour period. The proportions of subjects with ≥30% and ≥50% overall reduction in pain from baseline after 6 and 24 hours were significantly higher with meloxicam IV 30 mg doses versus placebo, but not with meloxicam IV 60 mg doses. The time to first use of rescue medication was significantly longer versus placebo with meloxicam IV 60 mg (P<0.05), but not with meloxicam IV 30 mg doses.ConclusionMeloxicam IV was generally safe and well tolerated in subjects with moderate-to-severe post-bunionectomy pain. Once-daily administration of meloxicam IV 30 mg and 60 mg exhibited rapid onset of analgesia (as early as 15 minutes) with maintenance of analgesic effect for two consecutive 24-hour periods.

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Postoperative Pain and Preemptive Local Anesthetic Infiltration in Hallux Valgus Surgery

Abstract: Preemptive local anesthetic infiltration was an efficient and safe method to reduce postoperative pain after hallux valgus surgery. The analgesic effect was satisfactory in both traditional and minimally invasive techniques.

Cited by 13 publications

References 40 publications

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

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

HYR-PB21-LA, a potential extended-release bupivacaine formulation, produces long-lasting local anesthesia in rats and guinea pigs

Evaluation of the safety and efficacy of an intravenous nanocrystal formulation of meloxicam in the management of moderate-to-severe pain after bunionectomy

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