Vázquez BR, Gómez GEE, Sánchez CR

Language: Spanish
References: 23
Page: 154-161
PDF size: 105.17 Kb.

ABSTRACT

Objective. To perform corrective surgery for hallux valgus under intra-articular anesthesia at the metatarso-phalangeal joint of the first toe. Materials and methods. A series of 54 patients (36 women, 18 men) with 83 feet, were operated on for correcting either hallux valgus or hallux rigidus by different techniques (Mc Bride, Keller, proximal first metatarsal osteotomy). Propofol-mydazolam is given intravenously for superficial sedation which is started before local anesthesia; 4 to 6 ml of a mixture of 4 ml of 0.5% bupivacaine altogether with 6 ml of 1:500 adrenalin in saline are injected into the articular space. The remaining mixture is used 2 ml for the colateral nerves on each side of the first metatarsal, and aditional infiltration is applied for the skin and to the zone of the first metatarsal base when a proximal osteotomy is planned. Results. Were uniformly excellent or good. Only 5 patients had a mild pain at starting operation, in whom the span of an average 10 minutes for anesthesia instalation was not completely respected. Post-operative analgesia was in average as long as 16 hours. Post-operative bleeding occurred in 8 cases, vasculitis in 6 and superficial infection in 3. No patient was needed to intubate or to applicate general anesthesia. Conclusion. Intra-articular anestesia is proposed as an effective method for hallux valgus correcting surgical procedures such as those described in the present paper. Complications are not atributable to the anesthetic procedure by itself.

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