Hallux valgus anesthesia
What anesthesia is used for hallux valgus surgery? Dr. Julien Lopez performs hallux valgus surgery under loco-regional anesthesia (ALR). As part of a hallux valgus operation, Dr. Lopez performs outpatient surgery. Such a procedure means there is a choice of what type of anesthesia is used.
Hallux valgus surgery: local or general anesthesia?
Most often, a hallux valgus surgery is conducted through local anesthesia or local-regional anesthesia (ALR), where only the foot is asleep. Combined with minimally invasive and percutaneous surgical techniques, loco-regional anesthesia ensures pain-free conditions for 6 to 12 hours and allows the practitioner to perform an outpatient surgery.
In some cases, general anesthesia for hallux valgus may be recommended, especially depending on the co-morbidities of the patient or his preference.
To avoid the pain of the hallux valgus operation, loco-regional anesthesia is the most common. This is conducted by injecting local anesthetics "in the vicinity" of the nerves of the ankle or knee (the ankle most often).
The anesthesia for the outpatient hallux valgus surgery is long-term. The anesthesiologist injects the anesthetic into the three or four nerves of the ankle, using ultrasound. After the injection, the foot falls asleep completely after about 20 minutes. To avoid the pain felt during injections, a mild sedation is used through infusion and then anesthesia is complete. When the patient wakes up, the foot is asleep and ready for surgery. With loco-regional anesthesia, the foot is completely asleep for 6 to 12 hours thanks to a painkilling block, which allows the patient to wake-up without pain. Other advantages are: local anesthesia avoids the disadvantages of general anesthesia but also reduces the risk of complications and improves recovery.
Hallux valgus and local anesthesia: the pre-aesthetic appointment
Before a hallux valgus operation using local anesthesia, it is necessary to make an appointment with the anesthesiologist. The pre-anesthetic consultation (CPA) is mandatory: it aims to prepare the procedure, especially if you have certain health problems.
To do so, you must contact the anesthesiologist's secretary to schedule a consultation. This must take place between 3 days and 3 months before the procedure. If you live far away, it is possible to consult by video conference. Contact information for the anesthesiologist's secretary will be communicated to you during the planning of the surgery with Dr Lopez.
For a consultation with the anesthesiologist, you must have all of your medical records:
- Recent reports of specialized consultations or hospitalization.
- Recent prescription of drugs.
The purpose of the pre-anesthetic consultation is to assess your current state of health and estimate the risks of anesthesia. You will have to complete a medical questionnaire so that the doctor can learn about possible conditions, procedures that have already happened, allergies and current drug treatments, if necessary.
If your health situation changes between these two periods, you must report it to the anesthesiologist before your operation.
How does hallux valgus surgery involve local anesthesia?
The operation of the hallux valgus under local anesthesia is relatively short and takes place on an outpatient basis. So you have the opportunity to go home on the day of the operation. However, it is necessary to be accompanied during the exit and the first night.
If an operation under local anesthesia for hallux valgus is not possible, you can be hospitalized 1 to 2 nights. Patients arriving from Corsica also have the possibility to plan a night at the clinic. The day before or the morning of the operation, you must take a preoperative shower and fast within six hours of the operation. The foot(s) involved in the operation must be cleaned. Consider removing nail polish and jewelry.
On the day of surgery, you will be transferred to the pre-anesthesia room for your hallux valgus surgery. You can then benefit from local or loco-regional anesthesia before entering the operating room.
Once the procedure is complete, you will be taken to the recovery room for surveillance and then to the room where a snack will be served. A nurse will monitor your condition and ensure that the surgical procedures are carried out correctly. We will accompany you the first time you get up out of bed and then you can return to your home in the hours that follow.
After leaving the operating room, the foot remains anesthetized for almost 12 hours. To avoid a sprained ankle and to enable walking, you will have been prescribed crutches: you will have the right to bear weight on your foot on the same day. That same evening, the anesthetic effect will gradually wear off. To anticipate the onset of pain, you will need to take the full painkilling treatment prescribed during the first 2 days and especially in the evening on your way home. If the treatment is not taken correctly, you run the risk of algoneurodystrophy. Note: Dr. Lopez is increasingly practicing pain management through home infusion prescriptions. In this case, you will be equipped with a portable balloon that continuously delivers painkillers. A specialized nurse will visit your home twice a day to monitor and verify that the equipment is working properly. The implementation of this system will be proposed to you in consultation by the surgeon during the preoperative consultation.