Prevalence of chronic pain syndrome in patients who have undergone hallux valgus percutaneous surgery: a comparison of sciatic-femoral and ankle regional ultrasound-guided nerve blocks

Abstract Background Chronic pain syndrome (CPS) is a common complication after operative procedures, and only a few studies have focused on the evaluation of CPS in foot-forefoot surgery and specifically on HV percutaneous correction. The objective of this study was to compare postoperative pain levels and incidence of CPS in two groups of patients having undergone femoral-sciatic nerve block or ankle block regional anaesthesia before hallux valgus (HV) percutaneous surgery and the association between postoperative pain levels and risk factors between these patient groups. Methods A consecutive patient series was enrolled and evaluated prospectively at 7 days, 1, 3 and 6 months after surgery. The participants were divided into two groups according to the regional anaesthesia received, femoral-sciatic nerve block or ankle block, and their outcomes were compared. The parameters assessed were postoperative pain at rest and during movement by the numerical rating scale (NRS), patient satisfaction using the Visual Analogue Scale (VAS), quality of life and return to daily activities. Statistical analysis was performed. Results One hundred fifty-five patients were assessed, 127 females and 28 males. Pain at rest (p < 0.0001) and during movement (p < 0.0001) significantly decreased during the follow-ups; at 6 months, 13 patients suffered from CPS. Over time, satisfaction remained stable (p > 0.05), quality of life significantly increased and patients returned to daily activities and work (p < 0.0001). No significant impact of type of anaesthesia could be detected. ASA 3 (p = 0.043) was associated to higher pain during movement; BMI (p = 0.005) and lumbago (p = 0.004) to lower satisfaction. No operative-anaesthetic complications were recorded. Postoperative pain at rest and during movement improved over time independently of the regional block used, with low incidence of CPS at last follow-up. Among risk factors, only a higher ASA was associated to higher pain during movement, while higher BMI and lumbago to lower satisfaction. Conclusions Both ultrasound-guided sciatic-femoral and ankle blocks were safe and effective in reducing postoperative pain with low incidence of CPS at last follow-up. Trial registration Clinical Trial NCT02886221. Registered 1 September 2016.

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Effect of a single dose of preoperative gabapentin in oncourology on the intensity of early postoperative pain

Pain medicine ◽

10.31636/pmjua.v5i4.3 ◽

2021 ◽

Vol 5 (4) ◽

pp. 16-21

Author(s):

I I Lisnyy ◽

L V Klimchuk

Keyword(s):

Single Dose ◽

Postoperative Pain ◽

Pain Relief ◽

Pain Syndrome ◽

Surgical Interventions ◽

Preoperative Administration ◽

Group 2 ◽

Pain At Rest ◽

Group 1

Objective: to evaluate the intensity of early postoperative pain after a single preoperative administration of gabapentin during surgical interventions in oncourology. Materials and methods: patients were randomized into two groups of 25 people each: group 1 (Gr. 1) received gabapentin at a dose of 300 mg for premedication at night, and group 2 (Gr. 2), in which patients did not receive gabapentin. The need for propofol during anesthesia, the need for fentanyl during anesthesia, and the intensity of pain at 2, 4, 6, 12 and 24 hours after surgery were assessed on the VAS scale at rest and during movement. Results of the study: it was shown that in patients who received gabapentin at a dose of 300 mg for premedication, the need for propofol and fentanyl was significantly lower when compared with patients who did not receive gabapentin, p = 0.0001. The intensity of postoperative pain syndrome in patients in Gr. 1 was significantly lower only when assessed at rest, while no statistically significant differences were found in the quality of pain relief during movement. Conclusions: the use of gabapentin at a dose of 300 mg for premedication significantly reduces the intensity of postoperative pain at rest, but not during movement, and also reduces the need for propofol and fentanyl during surgery.

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Movement-Evoked Pain Versus Pain at Rest in Postsurgical Clinical Trials and Meta-Analyses: Protocol for a Follow-Up Systematic Review

JMIR Research Protocols ◽

10.2196/15309 ◽

2020 ◽

Vol 9 (1) ◽

pp. e15309

Author(s):

Daenis Camiré ◽

Jason Erb ◽

Henrik Kehlet ◽

Timothy Brennan ◽

Ian Gilron

Keyword(s):

Systematic Review ◽

Clinical Trials ◽

Postoperative Pain ◽

Primary Outcome ◽

Outcome Measure ◽

Pain Treatment ◽

Pain Outcome ◽

Meta Analyses ◽

Pain At Rest

Background Postoperative pain is one of the most prevalent and disabling complications of surgery that is associated with personal suffering, delayed functional recovery, prolonged hospital stay, perioperative complications, and chronic postsurgical pain. Accumulating evidence has pointed to the important distinction between pain at rest (PAR) and movement-evoked pain (MEP) after surgery. In most studies including both measures, MEP has been shown to be substantially more severe than PAR. Furthermore, as MEP is commonly experienced during normal activities (eg, breathing, coughing, and walking), it has a greater adverse functional impact than PAR. In a previous systematic review conducted in 2011, only 39% of reviewed trials included MEP as a trial outcome and 52% failed to identify the pain outcome as either PAR or MEP. Given the recent observations of postsurgical pain trials that continue to neglect the distinction between PAR and MEP, this updated review seeks to evaluate the degree of progress in this area. Objective This updated review will include postsurgical clinical trials and meta-analyses in which the primary outcome was early postoperative pain intensity. The primary outcome for this review is the reporting of MEP (vs PAR) as an outcome measure for each trial and meta-analysis. Secondary outcomes include whether trials and meta-analyses distinguished between PAR and MEP. Methods To be consistent with the 2011 review that we are updating, this review will again focus on randomized controlled trials and meta-analyses, from Medical Literature Analysis and Retrieval System Online and EMBASE databases, focusing on pain treatment after thoracotomy, knee arthroplasty, and hysterectomy in humans. Trials and meta-analyses will be characterized as to whether or not they assessed PAR and MEP; whether their pain outcome acknowledged the distinction between PAR and MEP; and, for trials assessing MEP, which pain-evoking maneuver(s) were used. Results Scoping review and pilot data extraction are under way, and the results are expected by March 2020. Conclusions It is our belief that every postsurgical analgesic trial should include MEP as an outcome measure. The previous 2011 review was expected to have an impact on more widespread assessment of MEP in subsequent postoperative pain treatment trials. Thus, the purpose of this follow-up review is to reevaluate the frequency of use of MEP as a trial outcome, compared with PAR, in more recently published postoperative pain trials. Trial Registration PROSPERO CRD42019125855; https://tinyurl.com/qw9dty8 International Registered Report Identifier (IRRID) DERR1-10.2196/15309

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Experience of using Neurouridine® in various types of peripheral neuropathy

International Professional Journal Medicine ◽

10.31082/1728-452x-2020-217-218-7-8-29-36 ◽

2021 ◽

Vol 7-8 (217-218) ◽

pp. 29-36

Author(s):

Nazira Zharkinbekova ◽

◽

Aiganym Khamidulina ◽

Zhazira Barat ◽

Botagoz Rustemova ◽

...

Keyword(s):

Quality Of Life ◽

Chronic Pain ◽

Peripheral Neuropathy ◽

Pain Assessment ◽

Pain Syndrome ◽

Symptomatic Therapy ◽

Chronic Pain Syndrome ◽

Combination Drug ◽

Face Scale

The quality of life of patients with chronic pain syndrome remains one of the most pressing issues. Pain is considered chronic if it lasts or recurs for more than 3-6 months. This contributes to disability, depression, sleep disorders, poor quality of life, and what is important in this situation, the cost of treatment. According to statistics, the average prevalence of chronic pain in the adult population is 20%. Practitioners everywhere are in search of new methods of pain relief. Purpose of research. The quality of life of patients with chronic pain syndrome has traditionally remained a topical issue. Given the permanent nature of pain and the completeness of approaches to its relief, the modern Clinician is constantly looking for new treatment methods that meet the principles of evidence-based medicine and safety. Material and methods. This paper presents the results of using Neurouridine® in 30 patients with peripheral neuropathy. 30 patients were randomized for a 3-week treatment period. Average age: 47.5±1.5 years. All patients received standard symptomatic therapy, and an oral combination drug containing b vitamins, folic acid, choline, and Uridine was added to the treatment in the 150 mg mode once a day. Patients made three visits to the outpatient neurological office: visit 1-to evaluate pre-treatment, visit 2-after 10 days of treatment, and visit 3-after 20 days of treatment. Each patient was presented with two performance evaluations at each study visit: pain assessment on the CRS NRS scale, and the fps Face scale. Results and discussion. Analysis of the results of the treatment showed improvement in the form of reduced pain, improved quality of life in 65.90%, rapid recovery of performance in 32.10%, reduced need for analgesics in 59.90% and complete disappearance of symptoms in 25.30% of patients. Pain was assessed using the HI NRG scale, the AZA Face scale, and the frequency of analgesics at the patient's first, second, and third visits. Conclusion. The use of Neurouridine® for analgesic purposes has shown a positive effect on reducing symptoms in patients with peripheral neuropathy. The results confirm that this therapy provides a clear regeneration of the nerves, relieving pain, and reducing the soreness characteristic of nerve damage. Keyword: peripheral neuropathy, Neurouridine®, pain assessment, quality of life.

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Is Postoperative Chronic Pain Syndrome Higher with Mesh Repair of Inguinal Hernia?

The American Surgeon ◽

10.1177/000313481007601021 ◽

2010 ◽

Vol 76 (10) ◽

pp. 1115-1118 ◽

Cited By ~ 4

Author(s):

Kristin Masukawa ◽

Samuel E. Wilson

Keyword(s):

Chronic Pain ◽

Inguinal Hernia ◽

Postoperative Pain ◽

Hernia Repair ◽

Inguinal Hernia Repair ◽

Mesh Repair ◽

Pain Syndrome ◽

Chronic Pain Syndrome ◽

Chronic Postoperative Pain ◽

Anatomic Repair

Chronic postoperative pain has been associated with mesh repair in meta-analysis of clinical trials. We compared the incidence of early complications, recurrence, and chronic pain syndrome in anatomic and mesh repairs in 200 patients. We defined chronic pain syndrome as pain in the inguinal area more than 3 months after inguinal hernia repair, patient referral to pain management, or necessity of a secondary procedure for pain control. The mean follow-up time was 4 years and 2 months for anatomic repair and 3 years and 7 months for mesh repair. The clinical outcomes did not reveal a significant disparity between the 100 consecutive patients who had mesh repair versus the 100 patients who had anatomic repair with regard to the incidence of superficial wound infection (0 vs 2%, P = 0.497), testicular swelling (12 vs 7%, P = 0.335), hematoma (1 vs 0%, P = 0.99), recurrence (3 vs 2%, P = 0.99), or chronic postoperative pain (4 vs 1%, P = 0.369). The anatomic procedure without mesh should continue to be offered to patients who have an initial inguinal hernia repair.

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Spinal Cord Stimulation Is Effective in Management of Complex Regional Pain Syndrome I: Fact or Fiction

Neurosurgery ◽

10.1227/neu.0b013e3182181e60 ◽

2011 ◽

Vol 69 (3) ◽

pp. 566-580 ◽

Cited By ~ 71

Author(s):

Krishna Kumar ◽

Syed Rizvi ◽

Sharon Bishop Bnurs

Keyword(s):

Quality Of Life ◽

Spinal Cord ◽

Functional Status ◽

Complex Regional Pain Syndrome ◽

Spinal Cord Stimulation ◽

Pain Syndrome ◽

Sf 36

Abstract BACKGROUND: Complex regional pain syndrome (CRPS) I is a debilitating neuropathic pain disorder characterized by burning pain and allodynia. Spinal cord stimulation (SCS) is effective in the treatment of CRPS I in the medium term but its long-term efficacy and ability to improve functional status remains controversial. OBJECTIVE: To evaluate the ability of SCS to improve pain, functional status, and quality of life in the long term. METHODS: We retrospectively analyzed 25 patients over a mean follow-up period of 88 months. The parameters for evaluation were visual analog scale (VAS), Oswestry Disability Index (ODI), Beck Depression Inventory (BDI), EuroQoL-5D (EQ-5D) and Short Form 36 (SF-36), and drug consumption. Evaluations were conducted at point of entry, 3 months, 12 months, and last follow-up at 88 months (mean). RESULTS: At baseline, the mean scores were VAS 8.4, ODI 70%, BDI 28, EQ-5D 0.30, and SF-36 24. In general, maximum improvement was recorded at follow-up at 3 months (VAS 4.8, ODI 45%, BDI 15, EQ-5D 0.57, and SF-36 45). At last follow-up, scores were 5.6, 50%, 19, 0.57, and 40, respectively. Despite some regression, at last follow-up benefits were maintained and found to be statistically significant (P < .001) compared with baseline. Medication usage declined. SCS did not prevent disease spread to other limbs. Best results were achieved in stage I CRPS I, patients under 40 years of age, and those receiving SCS within 1 year of disease onset. CONCLUSION: SCS improves pain, quality of life, and functional status over the long term and consequently merits early consideration in the treatment continuum.

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Surgical Repair of Ileovesical Fistulas: Long-term Complications, Quality of Life, and Patient Satisfaction

The American Surgeon ◽

10.1177/000313481408001221 ◽

2014 ◽

Vol 80 (12) ◽

pp. 1207-1211 ◽

Cited By ~ 3

Author(s):

Jeffrey W. Hastings ◽

Malika Garg ◽

Elizabeth T. Lynn ◽

Celia M. Divino

Keyword(s):

Quality Of Life ◽

Patient Satisfaction ◽

Statistical Significance ◽

Retrospective Chart Review ◽

Administrative Database ◽

Low Incidence ◽

Assess Quality

Ileovesical fistulas (IVFs) are an uncommon complication of Crohn's disease. The aim of this study is to compare long-term surgical outcomes, assess quality of life, and quantify patient satisfaction after IVF repair. A retrospective chart review followed by a prospective survey was carried out. Survey questions focused on patient satisfaction and quality of life after repair of IVF. Fifty-one patients were identified from an administrative database. Mean follow-up was 4.3 years with a response rate of 51 per cent. At the time of the study, 0 per cent mortality and 16 per cent morbidity were recorded. No recurrence was noted. There was no statistical significance in incidence of complications between laparoscopic and open surgery. Statistically significant differences in single-stage versus multistage operations were found in postoperative day of discharge ( P < 0.001) and patient satisfaction ( P = 0.049). Ninety-eight per cent of patients reported extreme satisfaction with their surgery and an improvement in quality of life. A low incidence of morbidity and recurrence supports early surgical intervention in IVFs.

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Single Dose of Magnesium Sulfate as an Adjuvant to General Anesthesia Improves Pain Control, Discomfort and Quality of Sleep Postoperatively

Macedonian Medical Review ◽

10.1515/mmr-2016-0027 ◽

2016 ◽

Vol 70 (3) ◽

pp. 145-147

Author(s):

Biljana Kuzmanovska ◽

Marija Donevska Tolevska ◽

Andrijan Kartalov ◽

Marija Jovanovski Srceva ◽

Mirjana Shosholcheva ◽

...

Keyword(s):

Single Dose ◽

Postoperative Pain ◽

General Anesthesia ◽

Magnesium Sulfate ◽

Treated Group ◽

Control Group ◽

Quality Of Sleep ◽

Analgesic Consumption ◽

Pain At Rest

Abstract Introduction. As a N-methyl-D-aspartate receptors antagonist, magnesium may play a role in prevention of pain. The aim of this study was to assess the effects of single dose magnesium sulfate preoperatively on postoperative pain scores, discomfort and quality of sleep. Methods. Forty patients scheduled for elective laparoscopic cholecystectomy were randomized in two groups. Group A received 20 mg/kg magnesium sulfate after the anesthesia induction, prior to surgical incision, and Group B was the control group. Assessment was made for pain at rest in both groups according to VAS (0-10), analgesic consumption, discomfort and quality of sleep during first 48 hours postoperatively. Resultѕ. Compared to control group, magnesium-treated patients had lower postoperative pain at rest according to VAS score (p< 0.05) and consumed less analgesic drugs during the first 48 hours (p<0.05). The magnesium-treated group experienced less discomfort during the first and the second postoperative day. The magnesium-treated group reported no changes in sleeping pattern compared to preoperative sleeping pattern, while the control group showed an increase in insomnia during the first and the second postoperative night, compared to that preoperatively. Conclusion. Perioperative use of magnesium sulfate as an adjuvant to general anesthesia is associated with lower postoperative pain, less analgesic consumption, less discomfort and better sleep in the postoperative period.

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Movement-Evoked Pain Versus Pain at Rest in Postsurgical Clinical Trials and Meta-Analyses: Protocol for a Follow-Up Systematic Review (Preprint)

10.2196/preprints.15309 ◽

2019 ◽

Author(s):

Daenis Camiré ◽

Jason Erb ◽

Henrik Kehlet ◽

Timothy Brennan ◽

Ian Gilron

Keyword(s):

Systematic Review ◽

Clinical Trials ◽

Postoperative Pain ◽

Primary Outcome ◽

Outcome Measure ◽

Pain Treatment ◽

Pain Outcome ◽

Meta Analyses ◽

Pain At Rest

BACKGROUND Postoperative pain is one of the most prevalent and disabling complications of surgery that is associated with personal suffering, delayed functional recovery, prolonged hospital stay, perioperative complications, and chronic postsurgical pain. Accumulating evidence has pointed to the important distinction between pain at rest (PAR) and movement-evoked pain (MEP) after surgery. In most studies including both measures, MEP has been shown to be substantially more severe than PAR. Furthermore, as MEP is commonly experienced during normal activities (eg, breathing, coughing, and walking), it has a greater adverse functional impact than PAR. In a previous systematic review conducted in 2011, only 39% of reviewed trials included MEP as a trial outcome and 52% failed to identify the pain outcome as either PAR or MEP. Given the recent observations of postsurgical pain trials that continue to neglect the distinction between PAR and MEP, this updated review seeks to evaluate the degree of progress in this area. OBJECTIVE This updated review will include postsurgical clinical trials and meta-analyses in which the primary outcome was early postoperative pain intensity. The primary outcome for this review is the reporting of MEP (vs PAR) as an outcome measure for each trial and meta-analysis. Secondary outcomes include whether trials and meta-analyses distinguished between PAR and MEP. METHODS To be consistent with the 2011 review that we are updating, this review will again focus on randomized controlled trials and meta-analyses, from Medical Literature Analysis and Retrieval System Online and EMBASE databases, focusing on pain treatment after thoracotomy, knee arthroplasty, and hysterectomy in humans. Trials and meta-analyses will be characterized as to whether or not they assessed PAR and MEP; whether their pain outcome acknowledged the distinction between PAR and MEP; and, for trials assessing MEP, which pain-evoking maneuver(s) were used. RESULTS Scoping review and pilot data extraction are under way, and the results are expected by March 2020. CONCLUSIONS It is our belief that every postsurgical analgesic trial should include MEP as an outcome measure. The previous 2011 review was expected to have an impact on more widespread assessment of MEP in subsequent postoperative pain treatment trials. Thus, the purpose of this follow-up review is to reevaluate the frequency of use of MEP as a trial outcome, compared with PAR, in more recently published postoperative pain trials. CLINICALTRIAL PROSPERO CRD42019125855; https://tinyurl.com/qw9dty8 INTERNATIONAL REGISTERED REPORT DERR1-10.2196/15309

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NEUROTRANSMITTER IMBALANCES AND PSYCHOLOGICAL DYSFUNCTIONS AS PREDICATIVE FACTORS OF POSTOPERATIVE CHRONIC PAIN SYNDROME IN OPERATIVE GYNECOLOGY CENTER

Ulyanovsk Medico-biological Journal ◽

10.34014/2227-1848-2020-2-48-56 ◽

2020 ◽

pp. 48-56

Author(s):

L.N. Gumenyuk ◽

L.I. Seytumerova ◽

A.A. Serafimova ◽

A.V. Yatsiv

Keyword(s):

Chronic Pain ◽

Postoperative Pain ◽

Visual Analogue Scale ◽

Analogue Scale ◽

Depressive Disorders ◽

Pain Syndrome ◽

Chronic Pain Syndrome ◽

Chronic Postoperative Pain ◽

Group 2 ◽

Group 1

Chronic postoperative pain is one of the urgent medical and social problems of operative gynecology. The problem is preconditioned by a high prevalence rate, a significant impact on the outcomes of operative therapy and, as a consequence, patients’ quality of life. The goal of the paper is to study the role of preoperative neurotransmitter and psychoemotional dysfunctions in the development of postoperative chronic pain syndrome in an operative gynecology center. Materials and Methods. The study enrolled 156 patients aged 18–45 years who underwent planned surgical treatment for gynecological pathology. Patients were subsequently divided into 2 groups: Group 1 – women with postoperative chronic pain syndrome; Group 2 – women without chronic postoperative pain syndrome. The authors conducted general clinical examination, and also determined the levels of g-aminobutyric acid and β-endorphin in serum of patients using enzyme-linked immunosorbent assay. A visual analogue scale was used to assess quantitative characteristics of pain syndrome. Qualitative characteristics of pain syndrome were assessed according to the McGill Pain Questionnaire. HAM-A and HDRS were used to assess psychoemotional state. Results. Postoperative chronic pain was observed in 39.7 % of patients 12 months after surgery. In the preoperative period, a pain syndrome was registered in all patients. However, there were no significant intergroup differences in its severity. Statistically significant predominance of the affective scale indicators was revealed in the pain syndrome structure in Group 1, while Group 2 demonstrated predominance of the sensory scale indicators (p=0.003). Group 1 demonstrated more pronounced changes in GABA and β-endorphin levels. An inverse correlation was found between the level of β-endorphin and the affective and evaluative McGill questionnaire scales. Various affective pathologies were verified in Group 1. However, depressive disorders dominated. Group 2 demonstrated only subdepression and individual clinically unformed anxiety symptoms. The authors found out depressive disorder correlation with the severity of preoperative pain syndrome according to visual-analogue scale, McGill questionnaire affective scale, and β-endorphin concentration. Conclusion. Neurotransmitter disorders and psychological dysfunctions affect the formation of postoperative chronic pain syndrome. There is a correlation between chronic postoperative pain syndrome, preoperative β-endorphin concentration (r=-0.70; p=0.028), and the severity of depressive disorders (r=0.65; p=0.012), which confirms their role as non-specific prognostic markers while monitoring the postoperative chronic pain syndrome. Keywords: gynecological pathology, postoperative chronic pain syndrome, neurotransmitters, affective disorders. Хроническая послеоперационная боль – одна из актуальных медико-социальных проблем оперативной гинекологии, что обусловлено высоким уровнем распространенности, значительным влиянием на исходы хирургического лечения и, как следствие, качество жизни пациентов. Цель – изучение роли предоперационных нейромедиаторных и психоэмоциональных дисфункций в формировании хронического послеоперационного болевого синдрома в клинике оперативной гинекологии. Материалы и методы. В исследовании приняли участие 156 больных в возрасте от 18 до 45 лет, которым выполнено плановое хирургическое лечение по поводу гинекологической патологии. Пациенты в последующем были разделены на 2 группы: 1-я – женщины с хроническим послеоперационным болевым синдромом; 2-я – пациентки без хронического послеоперационного болевого синдрома. Наряду с общеклиническим обследованием c помощью иммуноферментного анализа определяли уровень кислоты и β-эндорфина в сыворотке крови. С целью оценки количественной характеристики боли применяли визуальную аналоговую шкалу, качественной – болевой опросник McGill, для оценки психоэмоционального статуса – клиническую шкалу HAM-A и HDRS. Результаты. Спустя 12 мес. после оперативного вмешательства хронический послеоперационный болевой синдром наблюдался у 39,7 % обследованных. В предоперационном периоде у всех обследованных отмечался болевой синдром, при этом достоверных межгрупповых различий его интенсивности не выявлено. В структуре болевого синдрома у пациенток 1-й группы выявлено статистически значимое преобладание показателей аффективной шкалы, у женщин 2-й группы – сенсорной (p=0,003). У пациенток 1-й группы изменения уровней ГАМК и β-эндорфина носили более выраженный характер. Установлена обратная корреляционная связь уровня β-эндорфина с показателями аффективной и эвалюативной шкал опросника McGill. Аффективная патология различной степени выраженности верифицирована у всех больных 1-й группы. В структуре преобладали депрессивные нарушения. У пациенток 2-й группы наблюдались лишь субдепрессивные состояния и отдельные, клинически не оформленные симптомы тревоги. Установлены корреляции депрессивных расстройств c выраженностью предоперационного болевого синдрома по визуально-аналоговой шкале, аффективной шкалой опросника McGill, концентрацией β-эндорфина. Выводы. Нейромедиаторные и психологические дисфункции влияют на формирование послеоперационного хронического болевого синдрома. Установлена связь между хроническим послеоперационным болевым синдромом и предоперационными значениями концентрации β-эндорфина (r=-0,70; p=0,028), выраженностью депрессивных расстройств (r=0,65; p=0,012), что подтверждает их роль как неспецифических прогностических маркеров при мониторинге формирования послеоперационного хронического болевого синдрома. Ключевые слова: гинекологическая патология, хронический послеоперационный болевой синдром, нейромедиаторы, аффективные расстройства.

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PO 18213 - Evaluation of hallux valgus treatment through percutaneous

Scientific Journal of the Foot & Ankle ◽

10.30795/scijfootankle.2019.v13.1034 ◽

2019 ◽

Vol 13 (Supl 1) ◽

pp. 46S

Author(s):

Jorge Eduardo De Schoucair Jambeiro ◽

Antero Tavares Cordeiro Neto ◽

Fernando Delmonte Moreira ◽

José Augusto De Oliveira ◽

Clara Cristiane Miguelino Sousa ◽

...

Keyword(s):

Hallux Valgus ◽

Surgical Trauma ◽

Complication Rates ◽

Percutaneous Surgery ◽

Aofas Score ◽

Level Of Evidence ◽

Percutaneous Procedures ◽

High Level

Introduction: Hallux valgus (HV) is characterized by the lateral deviation of the first finger, associated with pain and medial exostosis of the first metatarsus. The cause is usually multifactorial. The treatment varies with the degree of deformity and can be conservative or surgical. Percutaneous techniques have gained interest, offering less surgical trauma, fewer complications and faster recovery. The present study aims to evaluate the results of the surgical treatment of hallux valgus through percutaneous surgery. Methods: A search was performed in PubMed / Medline and BVS, from 2013 to 2018, using as descriptors "hallux valgus" and "percutaneous surgery". Original articles in English, Portuguese and Spanish were included. We excluded systematic reviews, descriptions of surgical technique and publications older than 5 years. The quality of the methodology was evaluated with the help of the STROBE tool, with an emphasis on hallux valgus (HVA), intermetatarsal angle (IMA) and the AOFAS score. Results: We found 185 references. After applying the inclusion and exclusion criteria, and STROBE tool, 5 articles were eligible, comprising a total of 290 percutaneous procedures. The follow-up time ranged from 6 months to 10 years. We found a reduction of IMA between 3.9º and 9.5º and a reduction of HVA between 12.5º and 26.8º. The AOFAS score ranged from 85 to 97.1 points in the evaluated works. Discussion: In general, we found a good correction of HV deformity with improvement of HVA, IMA, DMAA and clinical improvement by the postoperative AOFAS score, with low complication rates. However, the heterogeneity of the studies, with variation of techniques and samples did not allow us to generalize the findings. Conclusion: It was possible to note that percutaneous surgery for HV treatment produces good outcomes with low complication rates, but few studies had a high level of evidence demonstrating the efficacy of these techniques, despite encouraging preliminary results.

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