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Abstract
Purpose:
Modified Mau and Akin osteotomy for hallux valgus is followed by moderate to severe postoperative pain. Ultrasound-guided sciatic nerve block can be an effective option for pain control. We attempted to evaluate the efficacy of the ultrasound-guided sciatic nerve block in controlling postoperative pain.
Materials and Methods:
The charts of 59 consecutive patients were retrospectively reviewed between December 2014 and August 2015. Twenty-eight patients (the patient group) has received the ultrasound-guided sciatic nerve block after surgery, and 31 patients (the control group) has not received such procedure. The primary outcome was the satisfaction scale for postoperative pain control and postoperative visual analogue scale (VAS) score.
Results:
The VAS score at postoperative day one was significantly lower in the patient group than in the control group. The satisfaction scale for pain control for postoperative 1 day was significantly different between the two groups. In patient group, most patients have rated positively (‘strongly agree’ 42.9%, ‘agree’ 42.9%); however, in the control group, the rating scales were distributed relatively negatively (‘strongly agree’ 9.7%, ‘agree’ 22.6%, ‘neutral’ 29.0%, ‘disagree’ 25.8%, ‘strongly disagree’ 12.9%). The number of postoperative rescue analgesics injection was significantly lower in the patient group than in the control group.
REFERENCES
1.Singelyn FJ. Single-injection applications for foot and ankle sur-gery. Best Pract Res Clin Anaesthesiol. 2002. 16:247–54.
2.Grosser DM., Herr MJ., Claridge RJ., Barker LG. Preoperative lateral popliteal nerve block for intraoperative and postoperative pain control in elective foot and ankle surgery: a prospective analysis. Foot Ankle Int. 2227. 28:1271–5.
3.White PF., Issioui T., Skrivanek GD., Early JS., Wakefield C. The use of a continuous popliteal sciatic nerve block after surgery involving the foot and ankle: does it improve the quality of recovery? Anesth Analg. 2003. 97:1303–9.
4.Vadivelu N., Mitra S., Narayan D. Recent advances in postoperative pain management. Yale J Biol Med. 2010. 83:11–25.
5.Shoar S., Esmaeili S., Safari S. Pain management after surgery: a brief review. Anesth Pain Med. 2012. 1:184–6.
6.Turan I., Assareh H., Rolf C., Jakobsson J. Multi-modal-analgesia for pain management after Hallux Valgus surgery: a prospective randomised study on the effect of ankle block. J Orthop Surg Res. 2007. 2:26.
7.Kim BS., Shim DS., Lee JW., Han SH., Ko YK., Park EH. Comparison of multi-drug injection versus placebo after hallux valgus sur-gery. Foot Ankle Int. 2011. 32:856–60.
8.Gądek A., Liszka H. Preemptive local anesthetic infiltration in hallux valgus one-day surgery. Przegl Lek. 2015. 72:16–9.
9.Cho JH., Choi HJ., Kim YM., Kim JY., Wang BG., Lee WC. Usefulness of morphine in the periarticular multimodal drug local injection after surgery for hallux valgus. J Korean Foot Ankle Soc. 2013. 17:93–9.
10.Herr MJ., Keyarash AB., Muir JJ., Kile TA., Claridge RJ. Lateral trans-biceps popliteal block for elective foot and ankle surgery performed after induction of general anesthesia1 Foot Ankle Int. 2006. 27:667–71.
11.di Benedetto P., Casati A., Bertini L. Continuous subgluteus sciatic nerve block after orthopedic foot and ankle surgery: comparison of two infusion techniques. Reg Anesth Pain Med. 2002. 27:168–72.
12.Mendicino RW., Statler TK., Catanzariti AR. Popliteal sciatic nerve blocks after foot and ankle surgery: an adjunct to postoperative analgesia1 J Foot Ankle Surg. 2002. 41:338–41.
13.Turan I., Assareh H., Rolf C., Jakobsson J. Multi-modal-analgesia for pain management after Hallux Valgus surgery: a prospective randomized study on the effect of ankle block. J Orthop Surg Res. 2007. 2:26.
14.Sinatra RS., Torres J., Bustos AM. Pain management after major orthopaedic surgery: current strategies and new concepts. J Am Acad Orthop Surg. 2002. 10:117–29.
15.Collins L., Halwani A., Vaghadia H. Impact of a regional anesthesia analgesia program for outpatient foot surgery. Can J Anaesth. 1999. 46:840–5.
16.Mariano ER., Loland VJ., Sandhu NS., Bishop ML., Lee DK., Schwartz AK, et al. Comparative efficacy of ultrasound-guided and stimulating popliteal-sciatic perineural catheters for postoperative analgesia. Can J Anaesth. 2010. 57:919–26.
17.Costantini R., Affaitati G., Fabrizio A., Giamberardino MA. Controlling pain in the post-operative setting. Int J Clin Pharmacol Ther. 2011. 49:116–27.
18.Jakobsson JG. Pain management in ambulatory surgery: a re-view. Pharmaceuticals. 2014. 7:850–65.
19.Casati A., Vinciguerra F., Cappelleri G., Aldegheri G., Grispigni C., Putzu M, et al. Levobupivacaine 212% or 21125% for continuous sciatic nerve block: a prospective, randomized, double-blind comparison with 212% ropivacaine. Anesth Analg. 2004. 99:919–23.
20.Martín MA., Ollé G., Pellejero JA., Torruella R., Yuste M., Pou N. Comparison of the post-surgical analgesic effectiveness of tibial (at internal malleolus level) and common peroneal nerve block with infiltration of the surgical wound in outpatient surgery of the hallux valgus. Rev Esp Anestesiol Reanim. 2012. 59:197–203.
21.Peterson MK., Millar FA., Sheppard DG. Ultrasound-guided nerve blocks. Br J Anaesth. 2002. 88:621–4.
22.van Geffen GJ., van den Broek E., Braak GJ., Giele JL., Gielen MJ., Scheffer GJ. A prospective randomised controlled trial of ultrasound guided versus nerve stimulation guided distal sciatic nerve block at the popliteal fossa. Anaesth Intensive Care. 2009. 37:32–7.
23.Sites BD., Antonakakis JG. Ultrasound guidance in regional anesthesia: state of the art review through challenging clinical sce-narios. Local Reg Anesth. 2009. 2:1–14.
24.Rawal N. Postoperative pain treatment for ambulatory surgery. Best Pract Res Clin Anaesthesiol. 2007. 21:129–48.
Figure 1.
The trend in daily changes of pain scale after operation was significantly different between two groups (p<0.001).
Figure 2.
In patient group, most patients have rated positively (‘strongly disagree’ 0%, ‘disagree’ 3.6%, ‘neutral’ 10.7%, ‘agree’ 42.9%, ‘strongly agree’ 42.9%); however, in control group, rating scales were distributed relatively negatively (‘strongly disagree’ 12.9%, ‘disagree’ 25.8%, ‘neutral’ 29.0%, ‘agree’ 22.6%, ‘strongly agree’ 9.7%) (p=0.001). *Question: How would you rate the following? “Pain control was effective for 24 hours after operation.”
Table 1.
Demographic Data and Clinical Data for Patients
Table 2.
Difference of VAS between the Two Group
Table 3.
Difference of Tendency to Receive Same Operation for Other Foot between Two Groups
| Answer | Patient group (n=28) | Control group (n=31) |
|---|---|---|
| Yes* | 24 (96.0) | 22 (78.6) |
| No* | 1 (4.0) | 6 (21.4) |
| Total | 25 (100)† | 28 (100)† |
Values are presented as number (%). Patient group: patients who have received an ultrasound-guided sciatic nerve block after surgery, Control group: patients who have not received an ultrasound-guided sciatic nerve block after surgery. *Question: “Would you like to receive same operation for other foot, if you have hallux valgus?”
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