None listed
Conditions
Brief summary
This project has been designed to investigate whether one particular method of administering local anaesthetic around the knee in order to provide pain relief for patients undergoing foot surgery is better than the other. A routine part of anaesthesia for foot surgery performed in our unit is to perform a popliteal block. This involves injecting local anaesthetic around the nerves behind the knee to numb the foot and provide pain relief both during and after the operation. This block is performed either using an ultrasound machine to visualise the nerves or a nerve stimulator which stimulates the nerve. Both allow the anaesthetist to know the correct position to inject the local anaesthetic. We are planning to randomly allocate patients undergoing foot surgery to receive the block either with the ultrasound machine or with the nerve stimulator. We will then use a form to collect information about pain and pain relief requirements whilst the patient is in hospital to assess the efficacy of the block. We will also collect information about the length time to perform each block and patient satisfaction. Patients will be seen at routine follow up at 8 weeks and assessed to see if there are any ongoing problems related to the nerve block. We will analyse the data to see if one technique is superior to the other and modify our practise as appropriate.
Interventions
Ultrasound nerve localization with a Sonosite Nanomaxx ultrasound system using an L38n ultrasound probe in the 5-10MHz range or
Once the nerves have been adequately localized in the transverse plane below the level of the bifurcation. A double injection - a block of the Common Peroneal nerve and Posterior Tibial nerve is performed, the saphenous nerve is also blocked at the level of the knee
The local anaesthetic agent used is 20ml of Ropivicaine 0.75%
The block is inserted prior to prep
Ultrasound nerve localization with a Sonosite Nanomaxx ultrasound system using an L38n ultrasound probe in the 5-10MHz range or Once the nerves have been adequately localized in the transverse plane below the level of the bifurcation. A double injection - a block of the Common Peroneal nerve and Posterior Tibial nerve is performed, the saphenous nerve is also blocked at the level of the knee The local anaesthetic agent used is 20ml of Ropivicaine 0.75% The block is inserted prior to prepping and draping
Sponsors
Mr Harvinder Bedi
Study design
Allocation
Randomised controlled trial
Intervention model
Parallel
Primary purpose
Treatment
Masking
Blinded (masking used)
Eligibility
Sex/Gender
All
Age
18 Years to 100 Years
Healthy volunteers
No
Inclusion criteria
Foot Surgery which will last <90 mins and require an overnight stay. Calf tourniquet >18 yrs American Society of Anesthesiologists (ASA) score I - III
Exclusion criteria
Known neuropathies Diabetics with a neuropathy Patients receiving muscle relaxant Coagulopathy or on Anticoagulants Infection / Skin problems precluding injection of block Previous surgery in the popliteal region Allergy to local anaesthetic Patients on opioids for chronic analgesic therapy Patients with a known Chronic regional pain syndrome (CRPS) / neuroma Renal / liver failure where post operative analgesia can not be used
Outcome results
None listed