Quantification of Procedure Time and Infant Distress Produced (as Crying) When Percutaneous Achilles Tenotomy Is Performed under Topical Local Anaesthesia: A Preliminary Study
Abstract
:1. Introduction
2. Material and Method
- Inclusion criteria: Patients with congenital clubfoot, treated by the Ponseti method and whose age corresponds to the lactation stage (0 to 24 months).
- Exclusion criteria: Patients with neurological involvement and an associated pathology.
- Previous tenotomy Ponseti cast (60–70° abduction cast) removal.
- Application of topical local anaesthesia and occlusive dressing. We use a lidocaine and prilocaine preparation (cream) and we apply it with an occlusive dressing during 45 min after retiring the cast with 60–70° of abduction.
- Asepsis of the area.
- A 1-cm medial to lateral incision made, proximal to the calcaneal insertion, using an ophthalmic blade
- Complete section of the tendon, applying pressure to the area.
- Application of adhesive skin closures.
- Application of plaster cast, maintaining a dorsiflexion of 15–20° and the 60–70° abduction achieved with the previous cast, for 15 days.
- Voice recording (using Voice Memo App for iPhone X), placing the smartphone at a distance of 1 m from the infant.
- The recording starts when the scalpel is first applied and ends when the click of the complete tenotomy is heard and evidenced by the descent of the calcaneus.
- Crying intensity is measured using the Decibel 10 App (for iPhone X).
- The recording begins three minutes before the start of the procedure and continues until the crying stops.
3. Results
- Mean duration: 8.134 s.
- Standard deviation: 5.9798.
- Maximum value: 33.5 s; minimum value: 2.1 s.
- For 25% of patients, the duration was ≤4.115 s.
- For 50% of patients, the duration was ≤6.450 s.
- For 75% of patients, the duration was ≤10.185 s.
- Mean duration: 84.247 s.
- Standard deviation: 46.7309.
- Maximum value: 267.4 s; minimum value: 13.7 s.
- For 25% of patients, the duration was ≤58.55 s.
- For 50% of patients, the duration was ≤75.12 s.
- For 75% of patients, the duration was ≤92.58 s.
- Mean intensity: 88.999 dB.
- Standard deviation: 8.6189.
- Maximum value: 107.3 dB; minimum value: 67.6 dB.
- For 25% of patients, the mean intensity of crying was ≤81.9 dB.
- For 50% of patients, the mean intensity of crying was ≤89.1 dB.
- For 75% of patients, the mean intensity of crying was ≤96.05 dB.
- Mean intensity: 96.568 dB.
- Standard deviation: 8.1926.
- Maximum value: 116.2 dB; minimum value: 79.3 dB.
- For 25% of patients, the maximum intensity of crying was ≤90.15 dB.
- For 50% of patients, the maximum intensity of crying was ≤96.3 dB.
- For 75% of patients, the maximum intensity of crying was ≤103.35 dB.
4. Discussion
5. Conclusions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
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Vinyals Rodriguez, M.; Ey Batlle, A.; Jordan, I.; Míguez González, P. Quantification of Procedure Time and Infant Distress Produced (as Crying) When Percutaneous Achilles Tenotomy Is Performed under Topical Local Anaesthesia: A Preliminary Study. Int. J. Environ. Res. Public Health 2022, 19, 13842. https://doi.org/10.3390/ijerph192113842
Vinyals Rodriguez M, Ey Batlle A, Jordan I, Míguez González P. Quantification of Procedure Time and Infant Distress Produced (as Crying) When Percutaneous Achilles Tenotomy Is Performed under Topical Local Anaesthesia: A Preliminary Study. International Journal of Environmental Research and Public Health. 2022; 19(21):13842. https://doi.org/10.3390/ijerph192113842
Chicago/Turabian StyleVinyals Rodriguez, Marta, Anna Ey Batlle, Iolanda Jordan, and Paula Míguez González. 2022. "Quantification of Procedure Time and Infant Distress Produced (as Crying) When Percutaneous Achilles Tenotomy Is Performed under Topical Local Anaesthesia: A Preliminary Study" International Journal of Environmental Research and Public Health 19, no. 21: 13842. https://doi.org/10.3390/ijerph192113842