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ESRA19-0243 Foot and ankle surgery: blocking or knocking it? perioperative pain management review for foot and ankle surgery in a teaching hospital
  1. J Stewart,
  2. A Cormack and
  3. W Scott
  1. Glasgow Royal Infirmary, Anaesthetics, Glasgow, UK


Background and aims Pain is a well-recognised complication after foot and ankle surgery (FAS). Regional anaesthesia (RA) can be used to improve patient satisfaction and minimise inpatient stay. We have evaluated the efficacy of RA in post-operative pain management of patients undergoing elective FAS in a busy teaching hospital over a 12-month period. Focus was on recovery, 24h and breakthrough opioid requirements. The aim is availability of effective RA to all patients undergoing FAS.

Methods Retrospective electronic chart review of patients undergoing elective FAS in a large teaching hospital. Ethical approval was not required for service evaluation project.

Abstract ESRA19-0243 Figure 1

Type of Regional Anaesthesia

Results 98 patients were included in the study period (63% were female and 37% male). 52% were on chronic pain medications (neuropathic or long acting opioids) pre-operatively. 88% received RA for intra- and post-operative pain control. Patients were more likely to require opioids in recovery if RA was provided by a non-RA specialist (52% v 30%; Chart 2). Those patients who did not receive RA were more likely to require breakthrough opioids in the first 24 hours than those who received RA (43% v 32%).

Abstract ESRA19-0243 Figure 2

Use of postoperative IV opioids after RA performed by Regionalist v non-Regionalist

Conclusions RA was performed in 88% of cases. Where it was not used, it was largely due to patient preference or surgical factors. Use of RA by an RA specialist minimised recovery opioid requirements. The primary indicator of 24h opioid requirements was mainly dependent on surgical procedure. In conclusion, elective FAS lists should be covered by an RA specialist to deliver optimum service.

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