Department of Orthopaedics and Traumatology, Okmeydani Training and Research Hospital, Istanbul, Turkey.
Department of Anaesthesia and Resuscitation, Gaziosmanpaşa Taksim Ilkyardim Training and Research Hospital, Istanbul, Turkey.
Med Princ Pract. 2018;27(3):236-240. doi: 10.1159/000488321. Epub 2018 Mar 12.
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.
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.
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.
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.
足部拇外翻手术后患者常出现术后疼痛。本研究旨在评估全身麻醉下接受足部拇外翻手术的患者，踝部阻滞是否可以改善术后早期和中期的功能结局和疼痛管理。
这是一项随机对照试验，共纳入 60 例行全身麻醉下足部拇外翻手术的患者。患者前瞻性随机分为两组：单纯全身麻醉（A 组）和全身麻醉加踝部阻滞（B 组）。记录年龄、体重指数、止血带时间、手术时间、首次需要镇痛的时间、围术期镇痛方案、视觉模拟评分（VAS）、美国矫形足踝协会评分（AOFAS）和住院时间。采用 t 检验分析自变量，非参数数据采用 Mann-Whitney U 检验。
两组患者的年龄、性别、体重指数等一般资料差异无统计学意义。A 组患者的平均住院时间明显长于 B 组（p < 0.01）。B 组患者首次需要镇痛的时间长于 A 组（p < 0.01），术后需要的镇痛药物也少于 A 组。两组患者术前 VAS 和 AOFAS 评分差异无统计学意义。B 组术后第 1 天的 VAS 评分明显低于 A 组。术后 3、6、12 个月的随访发现，B 组的 VAS 评分明显低于 A 组，AOFAS 评分明显高于 A 组。
全身麻醉加踝部阻滞可改善足部拇外翻手术患者术后早期和中期的功能结局和疼痛管理。
