Mayo versus ankle block in minimally invasive hallux valgus surgery: A comparative study

Abstract

Background: Postoperative pain in foot surgeries can be significant, making regional anesthesia the preferred approach. Regional anesthesia enhances pain control, reduces sedative and opioid needs, shortens hospital stays, and improves patient satisfaction. The aim of this study is to compare the Ankle Block (AB) and the Mayo Block (MB) as a measure of postoperative analgesia for hallux valgus (HV) surgery.

Methods: This retrospective comparative study included patients with HV who underwent correction between November 2023 and July 2024. Patients received either an AB or MB with ropivacaine (7.5 mg/mL) for postoperative pain. The primary outcome was pain assessment at 12 and 24 h postoperatively using the Visual Analog Scale (VAS). Secondary outcomes were analgesic and opioid use, anesthesia duration in hours, and patient comfort on the first postoperative night. Statistical analysis was performed with a 5 % significance level, using R software.

Results: A total of 39 patients (57 feet) were included, with 20 receiving AB and 19 receiving MB. No statistically significant differences in primary outcome VAS scores were observed between groups at 12 or 24 h (p > 0.05). Analgesic and opioid use, as well as comfort on the first postoperative night, were similar between groups.

Conclusion: The Ankle Block and Mayo Block each proved effective in controlling postoperative pain following HV surgery. We recommend the use of the Mayo Block for percutaneous hallux valgus correction surgery, as it requires a smaller anesthetic volume, preserves plantar sensation, and may thus facilitate earlier mobilization and reduce the risk of falls.

Level of evidence: Level III, retrospective comparative study.

Keywords: Hallux valgus; Minimally invasive surgery; Percutaneous surgery; Peripheral nerve block; Postoperative pain; Regional anesthesia; Visual analog scale.