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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 :
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 postoperatively to day 3 using an acetimetry bracelet.
Pain, postoperative analgesic requirement, sleep quality and overall patient satisfaction (EVAN-LR) will also be assessed during the first 3 postoperative days.
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 :
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 (6 hours after ALR).
Deambulation and walking ability will be evaluated at home postoperatively to day 3 using an acetimetry bracelet.
Pain, postoperative analgesic requirement, sleep quality and overall patient satisfaction (EVAN-LR) will also be assessed during the first 3 postoperative days.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| plantar block | Active Comparator | 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). |
|
| Sciatic popliteal block | Active Comparator | Long lasting sciatic nerve block (ropivacaine 0,5% 100mg + 2mg dexamethasone) |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| PLANTAR BLOCK | Procedure |
|
| Measure | Description | Time Frame |
|---|---|---|
| Number of steps walking ability assessed by GAITRITE Test | Comparison of the deambulation assessed by GAITRITE test (walking test) between patient who received plantar block and patient who received sciatic popliteal block | 6 hours after ALR |
| Measure | Description | Time Frame |
|---|---|---|
| Quantity of postoperative rescue analgesics taken | Comparison of the postoperative pain assessed by the Quantity of post-operative rescue analgesics between each group of patients | up to 3 days after surgery |
| Assessment of the quality of the sensory blocks |
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Inclusion Criteria:
Exclusion Criteria:
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| UH Montpellier | Montpellier | Montpellier | 34000 | France |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 39102486 | Result | Swisser F, Brethe Y, Choquet O, Herteleer M, Bernard N, Laffont I, Bringuier S, Capdevila X. Plantar Compartment Block Improves Enhanced Recovery after Hallux Valgus Surgery: A Randomized, Comparative, Double-blind Study. Anesthesiology. 2024 Nov 1;141(5):891-903. doi: 10.1097/ALN.0000000000005180. |
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| Sciatic popliteal block | Procedure | 1-Sciatic popliteal block : patient in lateral position, injection of 20 ml of the mixture labelled " BLOC POPLITE " containing 20 ml of ropivacaine 0,5% (100mg) with 2mg (0,5 ml) of dexamethasone |
|
Comparison of the sensory territories of anesthesia using cold between each group |
| during the surgery |
| Assessment of the patient hospitalisation duration | Comparison of the duration of hospitalization between each group | up to 3 days after surgery |
| Assessment of overall patient satisfaction assessed by the scale EVAN Loco regional | Comparison of overall patient satisfaction between each group | up to 3 days after surgery |
| Assessment of sleep quality Assessment of patient sleep quality | Comparison of patient sleep quality assessed by the somnifer consumption during the postoperative hospitalization between each group | up to 3 days after surgery |
| Efficacity of patient walking ability | Comparison of the deambulation assessed by acetemeter between patient who received plantar block and patient who received sciatic popliteal block | up to 3 days after surgery |