Continuous Wound Infiltration After Hallux Valgus Surgery A Prospective, Randomized, Double-blind and Placebo-controlled Single-center Trial
Overview
- Phase
- Phase 4
- Intervention
- Wound infiltration catheter
- Conditions
- Hallux Valgus
- Sponsor
- Medical University Innsbruck
- Enrollment
- 50
- Locations
- 1
- Primary Endpoint
- Average Postoperative Numeric Rating Scale (NRS) for Pain
- Status
- Completed
- Last Updated
- 7 years ago
Overview
Brief Summary
The aim of this study is to investigate the effect of continuous wound infiltration with ropivacaine in comparison to standard pain management after elective distal metatarsal osteotomy for postoperative pain control.
Detailed Description
The aim of this study is to investigate the effect of continuous wound infiltration with ropivacaine in comparison to standard pain management after elective distal metatarsal osteotomy for postoperative pain control. The primary outcome parameters of this study were average pain and peak pain level on the verbal numeric rating scale (NRS; 1-10, higher numbers indicating increasing pain level) during the first 48 hours after surgery. The secondary outcome parameters included postoperative rescue opioid consumption, clinical outcome (AOFAS forefoot score, ROM of MTP joint of the greater toe), incidence of postoperative complications, and patient satisfaction with surgery on a numeric rating scale (1-10).
Investigators
Rainer Biedermann, MD
MD, PD
Medical University Innsbruck
Eligibility Criteria
Inclusion Criteria
- •All patients undergoing a distal metatarsal osteotomy (only Chevron or Scarf) and lateral release of the adductor halluces muscle with/without concomitant osteotomy of the proximal phalanx of the greater toe (Akin) for idiopathic hallux valgus deformity will be included.
Exclusion Criteria
- •hallux valgus surgery other then mentioned above or concomitant other procedures
- •denial to participate and give informed consent
- •patients with neurological diseases that affect the sensory-motor function
- •patients with any short-term (1 month) previous surgery on affected lower extremity
- •allergies or other comorbidity that prohibits standardized pain regime (renal insufficiency, severe heart or liver impairment, uncontrolled asthma, history of peptic ulcera )
- •patients unwilling to undergo surgery without general anesthesia
Arms & Interventions
NaCl 0,9%
Continuous wound infiltration NaCl 0,9% 2 ml/h for first 24 postoperative hours by wound infiltration catheter (InfiltraLong-Katheter 19G x 420mm; Pajunk Medizintechnologie GmbH)
Intervention: Wound infiltration catheter
NaCl 0,9%
Continuous wound infiltration NaCl 0,9% 2 ml/h for first 24 postoperative hours by wound infiltration catheter (InfiltraLong-Katheter 19G x 420mm; Pajunk Medizintechnologie GmbH)
Intervention: NaCl 0.9%
Ropivacaine
Continuous wound infiltration with Ropivacaine 0,2% 2 ml/h for first 24 postoperative hours by wound infiltration catheter (InfiltraLong-Katheter 19G x 420mm; Pajunk Medizintechnologie GmbH)
Intervention: Wound infiltration catheter
Ropivacaine
Continuous wound infiltration with Ropivacaine 0,2% 2 ml/h for first 24 postoperative hours by wound infiltration catheter (InfiltraLong-Katheter 19G x 420mm; Pajunk Medizintechnologie GmbH)
Intervention: Ropivacaine 0.2%
Outcomes
Primary Outcomes
Average Postoperative Numeric Rating Scale (NRS) for Pain
Time Frame: First 48 postoperative hours
The primary outcome parameters of this study were average pain and peak pain level on the verbal numeric rating scale (NRS; 1-10, higher numbers indicating increasing pain level) during the first 48 hours after surgery. NRS scores for pain were assessed by members of the nursing staff every 4 hours for 48 hours after the procedure (until discharge). Patients were instructed to rate their pain level on a scale from 0 to 10, with 0 meaning "no pain" and 10 indicating "pain as bad as it could be". Average postoperative numeric rating scale (NRS) for pain was calculated for each group (Placebo, Ropivacaine) by adding all postoperative NRS scores of all patients in each group (Placebo, Ropivacaine) to obtain the mean postoperative NRS score.
Peak Postoperative Numeric Rating Scale (NRS) for Pain
Time Frame: First 48 postoperative hours
The primary outcome parameters of this study were average pain and peak pain level on the verbal numeric rating scale (NRS; 1-10, higher numbers indicating increasing pain level) during the first 48 hours after surgery. NRS scores for pain were assessed by members of the nursing staff every 4 hours for 48 hours after the procedure (until discharge). Patients were instructed to rate their pain level on a scale from 0 to 10, with 0 meaning "no pain" and 10 indicating "pain as bad as it could be". Peak postoperative numeric rating scale (NRS) for pain was calculated for each group (Placebo, Ropivacaine) by adding the highest recorded NRS score for pain of all patients in each group (Placebo, Ropivacaine) to obtain the mean peak postoperative NRS score.
Secondary Outcomes
- Patient's Overall Satisfaction With Surgery(6 weeks)
- Patient's Overall Satisfaction With Pain Management(6 weeks)
- American Orthopaedic Foot and Ankle Society Score (AOFAS)(6 weeks)