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Abstract
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Background and Aims Hallux valgus (HV) surgery is associated with severe postoperative pain, requiring an anesthetic-analgesic strategy based on peripheral nerve blocks (PNB). Our goal was to assess the anesthetic strategy and postoperative pain control in HV ambulatory surgery.
Methods A descriptive observational retrospective study was designed and included 49 patients in 2021 at Hospital de la Santa Creu i Sant Pau, Spain. Anesthetic techniques, time to discharge and postoperative pain at 24 hours of surgery were collected. Ethical approval was taken from Institut d’Investigació Biomèdica Sant Pau (IIBSP-HAL-2023-62).
Results The most used anesthetic technique was PNB in 95.92%: Ankle block (AB), sciatic popliteal block (SPB) with posterior tibial nerve block (PTB) and SPB exclusively. Only 6.4% of patients required general anesthesia due to a failed blockade. No patient required opioids as rescue analgesia. The median hospital discharge time was 115 minutes (92.5 min for AB versus 120 min for other PNB), with no statistically significant differences. At discharge, all patients reported NPRS scores of 0. On the day after, 65,3% (n=32) of patients reported NPRS score. Both techniques were effective in achieving mild pain (NPRS 2).
Anesthetic technique
Periferal nerve blocks
NPRS 24h
Conclusions The utilization of PNB for HV ambulatory surgery led to favourable analgesic outcomes and low complication rates. The most frequent PNB was the AB (77.5%), with adjuvants added in 57.89% of patients, achieving effective postoperative analgesia without motor block, which should have facilitated earlier discharge. However, our findings suggest that further improvements to our outpatient surgery pathway are needed, as we did not observe differences in discharge times.
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