Prevalence of chronic pain syndrome in patients who have undergone hallux valgus percutaneous surgery: a comparison of sciatic-femoral and ankle regional ultrasound-guided nerve blocks

BMC Musculoskeletal Disorders

Manuela Funes¹  Gian-Mario Parise¹  Nicola Luigi Bragazzi²  Miki Dalmau-Pastor³  Pietro Ruggieri⁴  Gianfranco de Iudicibus⁴  Carlo Biz⁵  Elisa Belluzzi⁶ 

[1] Institute of Anesthesia and Reanimation, Department of Medicine DIMED, University of Padova, Padova, Italy;Laboratory for Industrial and Applied Mathematics, Department of Mathematics and Statistics, York University, Toronto, Canada;Minimally Invasive Foot and Ankle Society (MIFAS By Grecmip), 2 Rue Georges Negrevergne, 33700, Merignac, France;Human Anatomy and Embryology Unit, Department of Pathology and Experimental Therapeutics, School of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain;Orthopedics and Orthopedic Oncology, Department of Surgery, Oncology and Gastroenterology DiSCOG, University of Padova, via Giustiniani 3, 35128, Padova, Italy;Orthopedics and Orthopedic Oncology, Department of Surgery, Oncology and Gastroenterology DiSCOG, University of Padova, via Giustiniani 3, 35128, Padova, Italy;Minimally Invasive Foot and Ankle Society (MIFAS By Grecmip), 2 Rue Georges Negrevergne, 33700, Merignac, France;Orthopedics and Orthopedic Oncology, Department of Surgery, Oncology and Gastroenterology DiSCOG, University of Padova, via Giustiniani 3, 35128, Padova, Italy;Musculoskeletal Pathology and Oncology Laboratory, Orthopaedics and Orthopedics Oncology, Department of Surgery, Oncology and Gastroenterology DiSCOG, University of Padova, via Giustiniani 3, 3518, Padova, Italy;

关键词: Chronic pain;    Postoperative pain;    Hallux valgus;    Foot surgery;    Minimally invasive surgery;    Anaesthesia;    Ankle block;    Femoral-sciatic block;   

DOI  :  10.1186/s12891-021-04911-4

来源: Springer

【 摘 要 】

BackgroundChronic pain syndrome (CPS) is a common complication after operative procedures, and only a few studies have focused on the evaluation of CPS in foot-forefoot surgery and specifically on HV percutaneous correction. The objective of this study was to compare postoperative pain levels and incidence of CPS in two groups of patients having undergone femoral-sciatic nerve block or ankle block regional anaesthesia before hallux valgus (HV) percutaneous surgery and the association between postoperative pain levels and risk factors between these patient groups.MethodsA consecutive patient series was enrolled and evaluated prospectively at 7 days, 1, 3 and 6 months after surgery. The participants were divided into two groups according to the regional anaesthesia received, femoral-sciatic nerve block or ankle block, and their outcomes were compared. The parameters assessed were postoperative pain at rest and during movement by the numerical rating scale (NRS), patient satisfaction using the Visual Analogue Scale (VAS), quality of life and return to daily activities. Statistical analysis was performed.ResultsOne hundred fifty-five patients were assessed, 127 females and 28 males. Pain at rest (p < 0.0001) and during movement (p < 0.0001) significantly decreased during the follow-ups; at 6 months, 13 patients suffered from CPS. Over time, satisfaction remained stable (p > 0.05), quality of life significantly increased and patients returned to daily activities and work (p < 0.0001). No significant impact of type of anaesthesia could be detected. ASA 3 (p = 0.043) was associated to higher pain during movement; BMI (p = 0.005) and lumbago (p = 0.004) to lower satisfaction. No operative-anaesthetic complications were recorded. Postoperative pain at rest and during movement improved over time independently of the regional block used, with low incidence of CPS at last follow-up. Among risk factors, only a higher ASA was associated to higher pain during movement, while higher BMI and lumbago to lower satisfaction.ConclusionsBoth ultrasound-guided sciatic-femoral and ankle blocks were safe and effective in reducing postoperative pain with low incidence of CPS at last follow-up.Trial registrationClinical Trial NCT02886221. Registered 1 September 2016.

【 授权许可】

CC BY