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Postoperative pain following hindfoot surgery is often severe and can persist for several days. It frequently leads to the use of systemic analgesics, particularly opioids, whose adverse effects are well known. Furthermore, poorly controlled postoperative pain is a recognized independent risk factor for the development of chronic pain.
Ambulatory perineural catheter techniques, already used in our department for hindfoot surgeries, allow for continuous infusion of local anesthetic. They have demonstrated their efficacy in numerous orthopedic surgeries, but data specific to hindfoot surgery remain limited. It therefore seems appropriate to evaluate whether prolonged analgesia via a perineural catheter improves postoperative pain management and promotes functional recovery.
The study is conducted as a practice evaluation audit. It relies on the collection of data from routine care, without any modification to intraoperative care. This methodology allows for an objective evaluation of the benefits of the perineural catheter compared to a single-injection popliteal sciatic block with local anesthetic, while documenting the frequency and nature of complications associated with the technique (leaks, accidental or intentional catheter removal).
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| regional anesthesia |
| ||
| ambulatory perineural catheter |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Phone contact | Other | All patients are contacted by phone to assess pain during movement and at rest on each of the first 3 days after surgery, as well as their use of various pain medications |
| Measure | Description | Time Frame |
|---|---|---|
| Pain on movement using a numerical scale from 0 (no pain) to 11 (maximum pain) | to compare the efficacy of an ambulatory perineural catheter for prolonging analgesia and reducing postoperative pain following hindfoot surgery, compared with single-shot regional anesthesia | Day 1 postoperative |
| Measure | Description | Time Frame |
|---|---|---|
| postoperative pain at rest using a numerical scale from 0 (no pain) to 11 (maximum pain) | to assess analgesic efficacy at rest | From Baseline to Day 3 |
| postoperative pain during mobilization using a numerical scale from 0 (no pain) to 11 (maximum pain) |
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Inclusion Criteria:
Exclusion Criteria:
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University Hospital of Angers
| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Benjamin DUMARTINET | Contact | 241353637 | +33 | benjamin.dumartinet@chu-angers.fr |
| Name | Affiliation | Role |
|---|---|---|
| Benjamin DUMARTINET | University Hospital of Angers | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| University Hospital of Angers | Angers | France |
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| ID | Term |
|---|---|
| D000377 | Agnosia |
| ID | Term |
|---|---|
| D010468 | Perceptual Disorders |
| D019954 | Neurobehavioral Manifestations |
| D009461 | Neurologic Manifestations |
| D009422 | Nervous System Diseases |
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| ID | Term |
|---|---|
| D000765 | Anesthesia, Conduction |
| ID | Term |
|---|---|
| D000758 | Anesthesia |
| D000760 | Anesthesia and Analgesia |
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| perineural catheter | Device | Use of a perineural catheter for ambulatory analgesia |
|
| Regional Anesthesia | Procedure | regional anesthesia |
|
to evaluate the analgesic efficacy during mobilization |
| From Baseline to Day 3 |
| Postoperative consumption of morphine equivalents in milligrams | Cumulative | From Baseline to Day 3 |
| Daily postoperative consumption of morphine equivalents in milligrams | Daily | Baseline, Day 1, Day 2 and Day 3 |
| Postoperative use of non-opioid analgesics | Cumulative | From Baseline to Day 3 |
| Daily postoperative use of non-opioid analgesics | Daily | Baseline, Day 1, Day 2 and Day 3 |
| French Quality of Recovery -15 score (FQoR-15 - from 0 to 150) | to assess functional recovery and postoperative rehabilitation | Baseline and day 2 |
| number of complications | Accidental or intentional removal of the catheter Leaks at the injection site or in the infusion system Bruise or local infection Crashes potentially related to the residual engine block | From baseline to day 3 |
| proportion of patients experiencing at least one postoperative complication following hindfoot surgery | Readmission to the hospital Consultation with the attending physician for uncontrolled postoperative pain or complications related to the procedure Confirmed infection with antibiotic treatment initiated | From baseline to Day 3 |
| length of hospital stay, calculated in whole days | Duration censored on Day 3 if the patient is still hospitalized on that date | From Baseline to Day 3 |
| D012816 | Signs and Symptoms |
| D013568 | Pathological Conditions, Signs and Symptoms |