Turkish Journal of Anaesthesiology & Reanimation
ORIGINAL ARTICLE

Pain Management Optimisation by an Ultrasound-Guided Analgesic Technique in Outpatients with Plantar Fasciitis during High-Energy Extracorporeal Shock Wave Therapy

1.

Department of Emergency, Intensive Care Medicine and Anesthesia, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy

2.

Istituto di Anestesiologia e Rianimazione, Universita Cattolica Del Sacro Cuore, Rome, Italy

3.

Department of Orthopedic Surgery, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy

4.

Department of Obstetrics and Gynaecology, All India Institute of Medical Sciences, Patna, India

Turk J Anaesthesiol Reanim 2021; 49: 350-356
DOI: 10.5152/TJAR.2021.1465
Read: 381 Downloads: 59 Published: 22 October 2021

Objective: Several studies have demonstrated the efficacy of high-energy extracorporeal shock wave therapy (HESWT) for the treatment of painful foot diseases. A crucial complication of HESWT is the appearance of pain with the subsequent interruption of the procedure. The aim of this study was the evaluation of ultrasound (US)-guided posterior tibial nerve block (PTNB) efficacy in outpatients who discontinued the first application of HESWT due to surge of moderate-severe pain.

Methods: Twenty-one patients, scheduled for HESWT due to plantar fasciitis, who interrupted the treatment for surge of pain (numeric rating scale [NRS]  5), were enrolled. After interruption of the first treatment, the patients received US-guided PTNB for every subsequent HESWT session. The same skilled anaesthesiologist performed an US-guided PTNB all the times. Once the nerve was identified, the needle was inserted and 5ml mepivacaine 1% were injected. Intensity of pain during each procedure by NRS and evaluation of patient’s adherence to the treatment were detected.

Results: The HESWT was split into only three applications giving in average about 0.25 mJ mm–2, and all patients completed the treatment sessions. US-guided PTNB showed a significant reduction of NRS (P < 0.01) between the first HEWST without anaesthesia and the three subsequent treatments under peripheral block.

Conclusion: US-guided PTNB resulted a valid support for the HEWST in outpatients with plantar fasciitis because it reduced the pain during the procedure, allowing to minimise the patient discomfort and to give the therapeutic doses just in three sessions.

Cite this article as: Chierichini A, Spinazzola G, Conti C, et al. Pain Management Optimisation by an Ultrasound-Guided Analgesic Technique in Outpatients with Plantar Fasciitis during High-Energy Extracorporeal Shock Wave Therapy. Turk J Anaesth Reanim. 2021;49(5):350-356.

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