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

Med Princ Pract. 2018;27(3):236-240. doi: 10.1159/000488321. Epub 2018 Mar 12.

Abstract

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.

Keywords: Ankle nerve block; Foot function; General anesthesia; Hallux valgus; Postoperative pain.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Anesthetics, Local / administration & dosage*
  • Female
  • Hallux Valgus / surgery*
  • Humans
  • Male
  • Middle Aged
  • Nerve Block / methods*
  • Pain Management / methods*
  • Pain, Postoperative / drug therapy*
  • Pain, Postoperative / therapy*
  • Treatment Outcome

Substances

  • Anesthetics, Local