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).
Study Type
OBSERVATIONAL
Enrollment
60
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
Use of a perineural catheter for ambulatory analgesia
regional anesthesia
University Hospital of Angers
Angers, France
RECRUITINGPain on movement using a numerical scale from 0 (no pain) to 10 (maximum pain)
Postoperative pain on movement at Day 1. Pain intensity during movement assessed using an 11-point Numerical Rating Scale (NRS; 0 = no pain, 10 = worst possible pain)
Time frame: Day 1 postoperative
postoperative pain at rest using a numerical scale from 0 (no pain) to 10 (maximum pain)
to assess analgesic efficacy at rest
Time frame: Postoperative Day 0 through Postoperative Day 3
postoperative pain during mobilization using a numerical scale from 0 (no pain) to 10 (maximum pain)
to evaluate the analgesic efficacy during mobilization
Time frame: From Baseline to Day 3
Postoperative consumption of morphine equivalents in milligrams
Cumulative
Time frame: Postoperative Day 0 through Postoperative Day 3
Daily postoperative consumption of morphine equivalents in milligrams
Daily
Time frame: Baseline, Day 1, Day 2 and Day 3
Postoperative use of non-opioid analgesics
Cumulative
Time frame: Postoperative Day 0 through Postoperative Day 3
Daily postoperative use of non-opioid analgesics
Daily
Time frame: 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
Time frame: Postoperative Day 0 through Postoperative Day 2
Proportion of patients experiencing at least one adverse event related to the regional anesthesia technique
Accidental or intentional removal of the catheter Leaks at the injection site or in the infusion system Bruise or local infection Falls potentially related to the residual motor block
Time frame: Postoperative Day 0 through Postoperative 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
Time frame: Postoperative Day 0 through Postoperative Day 3
length of hospital stay, calculated in whole days
Duration censored on Day 3 if the patient is still hospitalized on that date
Time frame: Postoperative Day 0 through Postoperative Day 3
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