Luna Muhamad - Department of Anesthesiology
Waking up to postoperative pain is a frequent problem after procedures, especially as many patients undergoing surgery are only given general anesthesia. A study was done to evaluate whether general anesthesia with the addition of nerve blocks can help improve functional outcomes during surgery and reduce postsurgical pain. A nerve block is a method that involves the injection of local anesthetics to specific nerves to block pain signals. The duration of the block varies depending on the type of medication used, the area of the block, and the individual response. Does adding nerve blocks help with the functional outcomes and postsurgical pain?
In a randomized controlled trial, 60 patients who underwent a hallux valgus surgery that corrects the misalignment of the big toe under general anesthesia were split into two groups. Group A with only general anesthesia and group B with general anesthesia and an ankle nerve block added. Both groups had similar patient ages, demographics, and body masses. The study showed that group A patients had significantly longer average length of stay at the hospital compared to group B. Group B compared to group A had a longer duration of not needing a first analgesic to relieve pain after their surgery. In both groups, their visual analog scale (VAS), which is a scale used by patients to rate their pain level, was measured both preoperative and postoperative. While preoperative (VAS) was not significantly different between the 2 groups. The postoperative day 1 VAS scores were significantly lower in group B than in A, and in follow-ups after. The results of the study showed that nerve blocks used on top of general anesthesia in hallux valgus surgery may improve functional outcomes and reduce postsurgical pain.
The finding of general anesthesia and nerve blocks causing a significant decrease in patients' VAS may lead to future research that could explore optimized combinations of anesthetic techniques for different surgeries. The combination might lead to not only pain-free surgery but reduced levels of pain intensity during the recovery phase as well. Ultimately, such advancements made for pain would promote better overall recovery and patient satisfaction with surgeries.
References:
Kir MC, Kir G. Ankle Nerve Block Adjuvant to General Anesthesia Reduces Postsurgical Pain and Improves Functional Outcomes in Hallux Valgus Surgery. Med Princ Pract. 2018;27(3):236-240. doi: 10.1159/000488321. Epub 2018 Mar 12. PMID: 29529607; PMCID: PMC6062729.
Edited By: Firas Batrash, Editor-in-Chief
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