Postoperative Analgesia Using a Perineural Catheter Versus a Single Nerve Block in Rearfoot Surgery

Postoperative pain following hindfoot surgery is often severe and can persist for several days. It frequently leads to the use of systemic analgesics, particularly opioids, whose adverse effects are well known. Furthermore, poorly controlled postoperative pain is a recognized independent risk factor for the development of chronic pain. Ambulatory perineural catheter techniques, already used in our department for hindfoot surgeries, allow for continuous infusion of local anesthetic. They have demonstrated their efficacy in numerous orthopedic surgeries, but data specific to hindfoot surgery remain limited. It therefore seems appropriate to evaluate whether prolonged analgesia via a perineural catheter improves postoperative pain management and promotes functional recovery. The study is conducted as a practice evaluation audit. It relies on the collection of data from routine care, without any modification to intraoperative care. This methodology allows for an objective evaluation of the benefits of the perineural catheter compared to a single-injection popliteal sciatic block with local anesthetic, while documenting the frequency and nature of complications associated with the technique (leaks, accidental or intentional catheter removal).

Inclusion Criteria: * Adult patients; * Patients with an American Society of Anesthesiologists physical status (ASA score) of 1, 2, or 3; * Patients who have undergone hindfoot surgery; * Patients capable of completing the questionnaires. Exclusion Criteria: * Contraindications to regional anesthesia (known hypersensitivity to the local anesthetic, infection at the injection site, uncontrolled neurological condition); * Emergency surgery * Cognitive impairment; * Uncontrolled psychiatric condition; * Pregnancy or breastfeeding; * Substance abuse; * Use of neuroleptics or lithium; * Individuals subject to legal guardianship * Individuals deprived of liberty by judicial or administrative order * Patients who object to the study.