Analgesia, Hindfoot Surgery, Perineural Catheter
Conditions
Brief summary
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).
Interventions
OTHERPhone contact
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
DEVICEperineural catheter
Use of a perineural catheter for ambulatory analgesia
PROCEDURERegional Anesthesia
regional anesthesia
Sponsors
University Hospital, Angers
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Adult patients; * Patients with an American Society of Anesthesiologists physical status (ASA score) of 1, 2, or 3; * Patients who have undergone hindfoot surgery; * Patients capable of completing the questionnaires.
Exclusion criteria
* Contraindications to regional anesthesia (known hypersensitivity to the local anesthetic, infection at the injection site, uncontrolled neurological condition); * Emergency surgery * Cognitive impairment; * Uncontrolled psychiatric condition; * Pregnancy or breastfeeding; * Substance abuse; * Use of neuroleptics or lithium; * Individuals subject to legal guardianship * Individuals deprived of liberty by judicial or administrative order * Patients who object to the study.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Pain on movement using a numerical scale from 0 (no pain) to 10 (maximum pain) | Day 1 postoperative | 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) |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| postoperative pain at rest using a numerical scale from 0 (no pain) to 10 (maximum pain) | Postoperative Day 0 through Postoperative Day 3 | to assess analgesic efficacy at rest |
| postoperative pain during mobilization using a numerical scale from 0 (no pain) to 10 (maximum pain) | From Baseline to Day 3 | to evaluate the analgesic efficacy during mobilization |
| Postoperative consumption of morphine equivalents in milligrams | Postoperative Day 0 through Postoperative Day 3 | Cumulative |
| Daily postoperative consumption of morphine equivalents in milligrams | Baseline, Day 1, Day 2 and Day 3 | Daily |
| Postoperative use of non-opioid analgesics | Postoperative Day 0 through Postoperative Day 3 | Cumulative |
| Daily postoperative use of non-opioid analgesics | Baseline, Day 1, Day 2 and Day 3 | Daily |
| French Quality of Recovery -15 score (FQoR-15 - from 0 to 150) | Postoperative Day 0 through Postoperative Day 2 | to assess functional recovery and postoperative rehabilitation |
| Proportion of patients experiencing at least one adverse event related to the regional anesthesia technique | Postoperative Day 0 through Postoperative Day 3 | 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 |
| proportion of patients experiencing at least one postoperative complication following hindfoot surgery | Postoperative Day 0 through Postoperative Day 3 | 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 |
| length of hospital stay, calculated in whole days | Postoperative Day 0 through Postoperative Day 3 | Duration censored on Day 3 if the patient is still hospitalized on that date |
Countries
France
Contacts
CONTACTBenjamin DUMARTINET
PRINCIPAL_INVESTIGATORBenjamin DUMARTINET
University Hospital of Angers
Outcome results
None listed