Plantar Compartment Block Improves Enhanced Recovery after Hallux Valgus Surgery: A Randomized, Comparative,...

Area of Science:

• Anesthesiology
• Orthopedic Surgery
• Pain Management

Background:

• Enhanced recovery after foot surgery depends on walking ability.
• Plantar compartment block (PCB) is an alternative to popliteal sciatic nerve block (PSNB) for hallux valgus surgery analgesia.

Purpose of the Study:

• To compare PCB and PSNB for their effectiveness in restoring painless unaided walking post-hallux valgus surgery.

Main Methods:

• Prospective, double-blinded, randomized study comparing PCB with ropivacaine and dexamethasone versus PSNB with mepivacaine.
• Primary outcome: unaided walking ability at 6 hours post-surgery assessed via GAITRite mat.
• Secondary outcomes: gait quality, time to ambulation, pain levels, analgesic use, patient experience, and adverse events over 3 days.

Main Results:

• Significantly more patients in the PCB group (70%) walked unaided compared to the control group (13.8%; P < 0.001).
• PCB group showed improved gait quality (Functional Ambulation Profile score) and a shorter median time to home ambulation (9h vs 33.5h; P < 0.001).
• No significant differences in postoperative pain, rescue analgesic use, or patient experience were observed between groups.

Conclusions:

• Plantar compartment block (PCB) accelerates return to unaided walking and improves gait quality after hallux valgus surgery.
• PCB represents an innovative regional anesthesia strategy that enhances surgical recovery.
• Effective analgesia and reduced reliance on rescue analgesics are key benefits of PCB.