Plantar Compartment Block Versus Sciatic Block in Hallux Valgus Ambulatory Surgery : a Prospective, Randomised, Double Blind Study
Abstract
Hallux valgus surgery is known as a painful surgery. Qualitative pain management is the key to successful early recovery and rehabilitation.
Sciatic popliteal nerve block is widely used despite the risk of falling due to prolonged motor blockade.
Plantar block combined with distal peroneal block may be a better analgesic option in order to provide fast track rehabilitation.
This study aims to determine the quality of deambulation following hallux valgus surgery.
Block quality, post operative pain, patient satisfaction and length of hospital stay will be compared in this study.
Patients scheduled for ambulatory (hallux valgus) surgery under regional anaesthesia alone (without general anesthesia) will be recruited.
Consenting patients will be randomized the day of surgery to one of those two groups :
1. Short lasting sciatic nerve block (mepivacaine 1% 200mg) and long lasting plantar block (ropivacaine 0,5% 25mg + 2mg dexamethasone) with distal deep peroneal block (ropivacaine 0,5% 2ml).
2. Long lasting sciatic nerve block (ropivacaine 0,5% 100mg + 2mg dexamethasone)
All patients will benefit from post operative analgesia including paracetamol, nonsteroidal antiinflammatory drugs intravenously.
During PACU stay, pain will be assessed using the VAS (visual analogue scale) score, and analgesic IV consumption.
Temporospatial gait analysis will be assessed with a GAITRITE system before the patient leave the hospital.
Deambulation and walking ability will be evaluated at home…
How strong is the evidence?
Evidence Hub reads this as a randomized trial, done in people. Its evidence level is 2 of 5 (High · randomized trial). Randomized trials of a reasonable size are the strongest single-study design. Reported size: 60 participants or records.
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