[The management of post-surgical pain in the patient treated for hallux valgus with percutaneous and minimally invasive technique].
OBJECTIVE
In today's literature there are no defined guidelines for the treatment of postoperative pain in corrective surgery of hallux valgus. In this study we evaluated the use of a new treatment protocol designed to minimize the postoperative pain related to the surgical treatment of hallux valgus.


METHODS
The study involved 20 female patients (20 feet) treated for moderate to severe hallux valgus between September 2011 and December of 2012 with a percutaneous technique (10 feet) and minimally invasive surgery (Endolog System) (10 feet). All patients received postoperative as analgesic therapy 1 cp etoricoxib 120 mg/ day for 5 days + oxycodone hydrochloride/naloxone 5mg 1cp × 2/day for 15 days. The evaluation forms of pain VAS/VRS have been used for the evaluation of pre and postoperative pain at 15 and 30 days.


RESULTS
In both groups we found a significant reduction of pain in the days following surgery. At 30 days the VAS score was similar in between the two groups. Few and mild side effects were reported (1 case).


CONCLUSIONS
The co-administration of an anti-cox2 and an opioid in the first postoperative hours is useful to reduce soft tissue swelling and to control pain without causing significant side effects. The therapeutic protocol adopted, along with an adequate anesthesiological approach, has proved to be very effective for pain management in peri-and post-operative treatment of hallux valgus.
Dipartimento di Emergenza e Accettazione, Ortopedia e Traumatologia B. Policlinico Umberto I, Università "Sapienza", Roma. Italia.
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Di Giorgio
Dipartimento di Emergenza e Accettazione, Ortopedia e Traumatologia B. Policlinico Umberto I, Università "Sapienza", Roma. Italia.
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L
Sodano
Dipartimento di Emergenza e Accettazione, Ortopedia e Traumatologia B. Policlinico Umberto I, Università "Sapienza", Roma. Italia.
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G
Touloupakis
Dipartimento di Emergenza e Accettazione, Ortopedia e Traumatologia B. Policlinico Umberto I, Università "Sapienza", Roma. Italia.
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MG
Chiominto
Dipartimento Scienze cardiovascolari, respiratorie, nefrologiche, anestesiologiche e geriatriche. Policlinico Umberto I, Università "Sapienza", Roma. Italia.
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Rocco
D000328:Adult; D000368:Aged; D000701:Analgesics, Opioid / Q000627:therapeutic use*; D052246:Cyclooxygenase 2 Inhibitors / Q000627:therapeutic use*; D004359:Drug Therapy, Combination; D000077613:Etoricoxib; D005260:Female; D006215:Hallux Valgus / Q000601:surgery*; D006801:Humans; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures; D009270:Naloxone / Q000627:therapeutic use*; D009292:Narcotic Antagonists / Q000627:therapeutic use*; D019637:Orthopedic Procedures / Q000379:methods; D010098:Oxycodone / Q000627:therapeutic use*; D059408:Pain Management; D010149:Postoperative Pain / Q000188:drug therapy*; D011446:Prospective Studies; D011725:Pyridines / Q000627:therapeutic use*; D013450:Sulfones / Q000627:therapeutic use*
D000701:Analgesics, Opioid; D052246:Cyclooxygenase 2 Inhibitors; D009292:Narcotic Antagonists; D011725:Pyridines; D013450:Sulfones; D009270:Naloxone; D010098:Oxycodone; D000077613:Etoricoxib