Bunionectomy
Anesthesia Implications
Position: Supine, arms at side on armboards
Time: 30-60 min (short)
Blood Loss: Very Low (5-10 ml)
Post-op Pain: Minimal (1-3)
Maintenance Paralytic: No
Anesthetic Approaches
- MAC, Propofol Drip
The Anesthesia
Bolus timing – The most stimulating time for these surgeries is typically at the very beginning when the surgeon localizes the foot. Be ready to give a propofol bolus 1-2 minutes before.
The Pathophysiology
A bunion is otherwise known as a hallux valgus (HV) or hallux abductovalgus (HAV) malformation of the great toe. This condition can cause a great deal of pain.
Etiology – unclear.
Incidence – 23% of adults 18-65 years of age and 36% of adults over 65 years of age have this condition. The prevalence is greater among shod populations (those who wear shoes). The prevalence is 2:1 female to male.
