title: Comparison of multi-drug injection versus placebo after hallux valgus surgery.
abstract: BACKGROUND
  Hallux valgus surgery is followed by a significant amount of postoperative pain. Local multi-drug injection can be an option for pain control, but few clinical studies exist.
  
  
  METHODS
  Between May 2008 and July 2009, 30 consecutive patients (60 feet) received simultaneous bilateral proximal osteotomies for the correction of hallux valgus deformities. Each patient received local infiltration of the test solution made with ropivacaine, morphine, ketorolac, and epinephrine on one foot and same amount of normal saline on the other foot. The test side and the control side were randomly selected and both the patient and the surgeon remained blinded until the end of the data collection.
  
  
  RESULTS
  The multi-drug injection resulted in significantly less pain at 4 hours after the operation through the night of the first postoperative day. The difference in visual analogue scale (VAS) between the two sides was most significant at 8 hours after the operation, and then gradually decreased through the first and second postoperative day. Mean satisfaction VAS was significantly higher on the injection side (8.2+/-0.9) compared to the control side (6.2+/-1.9, p<0.0001).
  
  
  CONCLUSIONS
  Local multi-drug injection was easy to perform and safe and effective in reducing pain and enhancing patient satisfaction after hallux valgus surgery.
authors.affiliation: Department of Orthopaedic Surgery, Inha University Graduate School of Medicine, Incheon, Korea.
authors.forename: Born Soo
authors.initials: BS
authors.lastname: Kim
authors.forename: Dong Sik
authors.initials: DS
authors.lastname: Shim
authors.forename: Jin Woo
authors.initials: JW
authors.lastname: Lee
authors.forename: Seung Hwan
authors.initials: SH
authors.lastname: Han
authors.forename: Yong Kon
authors.initials: YK
authors.lastname: Ko
authors.forename: Eui Hyun
authors.initials: EH
authors.lastname: Park
mesh_terms: D000328:Adult; D000577:Amides / Q000008:administration & dosage; D000779:Anesthetics, Local / Q000008:administration & dosage*; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000008:administration & dosage; D004837:Epinephrine / Q000008:administration & dosage; D005260:Female; D006215:Hallux Valgus / Q000601:surgery*; D006801:Humans; D020911:Ketorolac Tromethamine / Q000008:administration & dosage; D008297:Male; D008875:Middle Aged; D009020:Morphine / Q000008:administration & dosage; D010147:Pain Measurement; D010149:Postoperative Pain / Q000517:prevention & control*; D017060:Patient Satisfaction; D000077212:Ropivacaine
chemical_list: D000577:Amides; D000779:Anesthetics, Local; D000894:Anti-Inflammatory Agents, Non-Steroidal; D020911:Ketorolac Tromethamine; D009020:Morphine; D000077212:Ropivacaine; D004837:Epinephrine