ReviewPain Management for Elective Foot and Ankle Surgery: A Systematic Review of Randomized Controlled Trials
Section snippets
Materials and Methods
A systematic review of the published data concerning pain management after foot and ankle surgery was conducted according to the “Preferred Reporting Items for Systematic Reviews and Meta-Analyses” guidelines (4). The data search was performed using Ovid MEDLINE, the Cochrane Database of Systematic Reviews, the Database of Abstracts of Reviews of Effects, and the Cochrane Central Register of Controlled Trials databases from January 1946 to February 2013 according to the protocol recommended by
Results
A total of 953 studies of analgesic interventions after foot and ankle surgery were identified, of which 45 studies were included in the systematic review. A flow chart of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses diagram is shown in the Fig. Table 1, Table 2, Table 3 provide details of the included studies 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25, 26, 27, 28, 29, 30, 31, 32, 33, 34, 35, 36, 37, 38, 39, 40, 41, 42, 43, 44, 45, 46, 47,
Discussion
The present systematic review has provided salient observations regarding pain management after foot and ankle surgery. The evidence from the included studies, data from surgical procedures with a similar pathophysiology of pain (e.g., other orthopedic surgical procedures) 2, 3, and the current understanding of a multimodal analgesia approach have allowed the development of optimal pain management strategies for patients undergoing foot and ankle surgery (Table 4).
The use of multimodal
References (62)
Multimodal analgesia techniques and postoperative rehabilitation
Anesthesiol Clin North Am
(2005)- et al.
Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement
J Clin Epidemiol
(2009) - et al.
Assessing the quality of report randomized control trials: is blinding necessary?
Control Clin Trial
(1996) - et al.
The efficacy of ANSAID (flurbiprofen) as an analgesic in foot surgery
J Foot Ankle Surg
(1997) - et al.
Diclofenac potassium liquid-filled soft gelatin capsules in the management of patients with postbunionectomy pain: a phase III, multicenter, randomized, double-blind, placebo controlled study conducted over 5 days
Clin Ther
(2009) - et al.
Local anesthesia for arthroscopic surgery of the ankle using pethidine or prilocaine
Arthroscopy
(1997) - et al.
Clinical properties of levobupivacaine or racemic bupivacaine for sciatic nerve block
J Clin Anesth
(2002) - et al.
Continuous subgluteus sciatic nerve block after orthopedic foot and ankle surgery: comparison of two infusion techniques
Reg Anesth Pain Med
(2002) - et al.
Additional femoral catheter in combination with popliteal catheter for analgesia after major ankle surgery
Br J Anaesth
(2011) - et al.
The use of a local anesthetic foot block in patients undergoing outpatient bony forefoot surgery: a prospective randomized controlled trial
J Foot Ankle Surg
(2003)
Falls and major orthopaedic surgery with peripheral nerve blockade: a systematic review and meta-analysis
Br J Anaesth
Single dose intravenous paracetamol or propacetamol for prevention or treatment of postoperative pain: a systematic review and meta-analysis
Br J Anaesth
Paracetamol and selective and non-selective non-steroidal anti-inflammatory drugs for the reduction in morphine related side-effects after major surgery: a systematic review
Br J Anaesth
Impact of perioperative dexamethasone on postoperative analgesia and side-effects: systematic review and metaanalysis
Br J Anaesth
Current concepts review: regional anesthesia for foot and ankle surgery
Foot Ankle Int
Procedure-specific pain management: the road to improve postsurgical pain management?
Anesthesiology
Parenteral versus oral route increases paracetamol efficacy
Clin Drug Invest
Double-blind comparative study of niflumic acid versus placebo in the surgical treatment of hallux valgus
Curr Ther Res Clin Exp
Diclofenac potassium liquid-filled soft gelatin capsules for the treatment of postbunionectomy pain
Curr Med Res Opin
An enhanced bunionectomy model as a potential tool for early decision-making in the development of new analgesics
Adv Ther
A randomized controlled study comparing rofecoxib, diclofenac sodium, and placebo in post-bunionectomy pain
Curr Med Res Opin
Analgesic efficacy of valdecoxib for acute postoperative pain after bunionectomy
J Am Podiatr Med Assoc
Pain management after elective hallux valgus surgery: a prospective randomized double-blind study comparing etoricoxib and tramadol
Anesth Analg
Analgesic efficacy of preoperative parecoxib sodium in an orthopedic pain model
J Am Podiatr Med Assoc
Multiple-day efficacy of parecoxib sodium treatment in postoperative bunionectomy pain
Clin J Pain
Analgesic efficacy of inhaled morphine in patients after bunionectomy surgery
Anesthesiology
Analgesic efficacy and safety of morphine-chitosan nasal solution in patients with moderate to severe pain following orthopedic surgery
Pain Med
The efficacy and tolerability of multiple-dose tapentadol immediate release for the relief of acute pain following orthopedic (bunionectomy) surgery
Curr Med Res Opin
Analgesic and adverse effects of a fixed-ratio morphine-oxycodone combination (MoxDuo) in the treatment of postoperative pain
J Opioid Manag
Dexamethasone decreases oxycodone consumption following osteotomy of the first metatarsal bone: a randomized controlled trial in day surgery
Acta Anaesthesiol Scand
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Financial Disclosure: None reported.
Conflict of Interest: Girish P. Joshi has received honoraria from Pfizer, Pacira, and Cadence Pharmaceuticals; none reported for the other authors.