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Comparison Between Ultrasonography-Guided Popliteal Sciatic Nerve Block and Spinal Anesthesia for Hallux Valgus Repair

Background: We aimed to compare the efficacy, postoperative pain scores, adverse effects, additional analgesic requirements, and patient satisfaction scores of ultrasonography-guided sciatic nerve block by popliteal approach with spinal anesthesia for hallux valgus correction surgery. Methods: Sixty...

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Published in:Foot & ankle international 2016-01, Vol.37 (1), p.85-89
Main Authors: Karaarslan, Sermin, Tekgül, Zeki Tuncel, Şimşek, Esen, Turan, Murat, Karaman, Yücel, Kaya, Ahmet, Gönüllü, Mustafa
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container_title Foot & ankle international
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creator Karaarslan, Sermin
Tekgül, Zeki Tuncel
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Gönüllü, Mustafa
description Background: We aimed to compare the efficacy, postoperative pain scores, adverse effects, additional analgesic requirements, and patient satisfaction scores of ultrasonography-guided sciatic nerve block by popliteal approach with spinal anesthesia for hallux valgus correction surgery. Methods: Sixty patients scheduled for hallux valgus correction surgery were enrolled in this prospective randomized study. Unilateral spinal block was performed on patients in the spinal anesthesia group. Popliteal block group patients received popliteal sciatic nerve block with guidance by both nerve stimulator and ultrasonography. Durations of anesthetic and operative interventions and time until the initiation of surgery were recorded for both groups. Pain magnitude of the patients at the 2nd, 4th, 6th, 12th, and 24th hours following anesthetic interventions were assessed with a visual analog scale (VAS). Adverse effects such as postoperative urinary retention and postdural puncture headache were recorded. Also, patient satisfaction was recorded. Patients were interviewed by phone for anesthetic and operative complications at 72 hours postoperatively. Results: Spinal anesthesia group patients exhibited hypotension, bradycardia, postdural puncture headache, and urinary retention rates of 6.6%, 3.3%, 10%, and 3.3%, respectively. Popliteal block group patients showed none of these adverse effects. Moreover, VAS scores of the patients at the 2nd, 4th, 6th, and 12th hours were significantly lower (P < .001, P = .003, P < .001, P
doi_str_mv 10.1177/1071100715600285
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Methods: Sixty patients scheduled for hallux valgus correction surgery were enrolled in this prospective randomized study. Unilateral spinal block was performed on patients in the spinal anesthesia group. Popliteal block group patients received popliteal sciatic nerve block with guidance by both nerve stimulator and ultrasonography. Durations of anesthetic and operative interventions and time until the initiation of surgery were recorded for both groups. Pain magnitude of the patients at the 2nd, 4th, 6th, 12th, and 24th hours following anesthetic interventions were assessed with a visual analog scale (VAS). Adverse effects such as postoperative urinary retention and postdural puncture headache were recorded. Also, patient satisfaction was recorded. Patients were interviewed by phone for anesthetic and operative complications at 72 hours postoperatively. Results: Spinal anesthesia group patients exhibited hypotension, bradycardia, postdural puncture headache, and urinary retention rates of 6.6%, 3.3%, 10%, and 3.3%, respectively. Popliteal block group patients showed none of these adverse effects. Moreover, VAS scores of the patients at the 2nd, 4th, 6th, and 12th hours were significantly lower (P &lt; .001, P = .003, P &lt; .001, P &lt;.001, respectively), postoperative first analgesic requirement times were significantly longer (P &lt; .001), and pain satisfaction scores were significantly higher (P &lt; .001) in the popliteal block group. Conclusion: Given the complications related to spinal anesthesia and its insufficiency to maintain analgesia postoperatively, we believe the preferred anesthetic method should be peripheral nerve blocks for hallux valgus correction surgeries. Level of Evidence: Level I, randomized prospective study.</description><identifier>ISSN: 1071-1007</identifier><identifier>EISSN: 1944-7876</identifier><identifier>DOI: 10.1177/1071100715600285</identifier><identifier>PMID: 26293156</identifier><language>eng</language><publisher>Los Angeles, CA: SAGE Publications</publisher><subject>Adult ; Anesthesia, Spinal - adverse effects ; Bradycardia - etiology ; Female ; Hallux Valgus - surgery ; Humans ; Hypotension - etiology ; Male ; Nerve Block ; Pain, Postoperative - prevention &amp; control ; Patient Satisfaction ; Post-Dural Puncture Headache - etiology ; Prospective Studies ; Sciatic Nerve - diagnostic imaging ; Ultrasonography, Interventional ; Urinary Retention - etiology ; Visual Analog Scale</subject><ispartof>Foot &amp; ankle international, 2016-01, Vol.37 (1), p.85-89</ispartof><rights>The Author(s) 2015</rights><rights>The Author(s) 2015.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c337t-352243cbd8bbe034c88cd975c81c1813bc0610e7212a3314e3eb849909200da73</citedby><cites>FETCH-LOGICAL-c337t-352243cbd8bbe034c88cd975c81c1813bc0610e7212a3314e3eb849909200da73</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,778,782,27907,27908,79115</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/26293156$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Karaarslan, Sermin</creatorcontrib><creatorcontrib>Tekgül, Zeki Tuncel</creatorcontrib><creatorcontrib>Şimşek, Esen</creatorcontrib><creatorcontrib>Turan, Murat</creatorcontrib><creatorcontrib>Karaman, Yücel</creatorcontrib><creatorcontrib>Kaya, Ahmet</creatorcontrib><creatorcontrib>Gönüllü, Mustafa</creatorcontrib><title>Comparison Between Ultrasonography-Guided Popliteal Sciatic Nerve Block and Spinal Anesthesia for Hallux Valgus Repair</title><title>Foot &amp; ankle international</title><addtitle>Foot Ankle Int</addtitle><description>Background: We aimed to compare the efficacy, postoperative pain scores, adverse effects, additional analgesic requirements, and patient satisfaction scores of ultrasonography-guided sciatic nerve block by popliteal approach with spinal anesthesia for hallux valgus correction surgery. 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Results: Spinal anesthesia group patients exhibited hypotension, bradycardia, postdural puncture headache, and urinary retention rates of 6.6%, 3.3%, 10%, and 3.3%, respectively. Popliteal block group patients showed none of these adverse effects. Moreover, VAS scores of the patients at the 2nd, 4th, 6th, and 12th hours were significantly lower (P &lt; .001, P = .003, P &lt; .001, P &lt;.001, respectively), postoperative first analgesic requirement times were significantly longer (P &lt; .001), and pain satisfaction scores were significantly higher (P &lt; .001) in the popliteal block group. Conclusion: Given the complications related to spinal anesthesia and its insufficiency to maintain analgesia postoperatively, we believe the preferred anesthetic method should be peripheral nerve blocks for hallux valgus correction surgeries. 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Methods: Sixty patients scheduled for hallux valgus correction surgery were enrolled in this prospective randomized study. Unilateral spinal block was performed on patients in the spinal anesthesia group. Popliteal block group patients received popliteal sciatic nerve block with guidance by both nerve stimulator and ultrasonography. Durations of anesthetic and operative interventions and time until the initiation of surgery were recorded for both groups. Pain magnitude of the patients at the 2nd, 4th, 6th, 12th, and 24th hours following anesthetic interventions were assessed with a visual analog scale (VAS). Adverse effects such as postoperative urinary retention and postdural puncture headache were recorded. Also, patient satisfaction was recorded. Patients were interviewed by phone for anesthetic and operative complications at 72 hours postoperatively. Results: Spinal anesthesia group patients exhibited hypotension, bradycardia, postdural puncture headache, and urinary retention rates of 6.6%, 3.3%, 10%, and 3.3%, respectively. Popliteal block group patients showed none of these adverse effects. Moreover, VAS scores of the patients at the 2nd, 4th, 6th, and 12th hours were significantly lower (P &lt; .001, P = .003, P &lt; .001, P &lt;.001, respectively), postoperative first analgesic requirement times were significantly longer (P &lt; .001), and pain satisfaction scores were significantly higher (P &lt; .001) in the popliteal block group. Conclusion: Given the complications related to spinal anesthesia and its insufficiency to maintain analgesia postoperatively, we believe the preferred anesthetic method should be peripheral nerve blocks for hallux valgus correction surgeries. 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subjects Adult
Anesthesia, Spinal - adverse effects
Bradycardia - etiology
Female
Hallux Valgus - surgery
Humans
Hypotension - etiology
Male
Nerve Block
Pain, Postoperative - prevention & control
Patient Satisfaction
Post-Dural Puncture Headache - etiology
Prospective Studies
Sciatic Nerve - diagnostic imaging
Ultrasonography, Interventional
Urinary Retention - etiology
Visual Analog Scale
title Comparison Between Ultrasonography-Guided Popliteal Sciatic Nerve Block and Spinal Anesthesia for Hallux Valgus Repair
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