Foot Surgery
Conditions
Keywords
Pain, Surgery, Catheter, Nerve Block, Popliteal, Subgluteal, Sciatic, UCSD, Moderate-to-severe pain, Perineural Catheter, Orthopedic Surgery, foot surgery surgery, sciatic perineural catheter, age =>18
Brief summary
To determine the relationship between perineural catheter location along the sciatic nerve (popliteal versus subgluteal placement) and infusion effects for ultrasound-guided continuous sciatic nerve blocks.
Interventions
PROCEDURESubgluteal Sciatic Nerve Block
Patients randomized to this group will receive a sciatic nerve block with the catheter tip insertion at the subgluteal location 1-3 cm caudad to the inferior border of the gluteus maximus muscle. After catheter placement, outcome measures will be assessed.
PROCEDUREPopliteal Sciatic Nerve Block
Patients randomized to this group will receive a sciatic nerve block with the catheter tip insertion at the popliteal location 1-3 cm cephalad to the sciatic bifurcation. After Catheter placement outcome measures will be assessed.
Sponsors
University of California, San Diego
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* undergoing foot surgery with a sciatic perineural catheter for postoperative analgesia * spending the first postoperative night hospitalized * age 18 years or older
Exclusion criteria
* pregnancy * inability to communicate with the investigators and hospital staff * incarceration * clinical neuropathy in the surgical extremity
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Muscle Strength (MVIC) of the hamstring muscles | 08:00-09:00 morning after surgery as a percentage of baseline | We will evaluate hamstring strength which is innervated by the sciatic nerve with an isometric force electromechanical dynamometer to measure the force produced during a maximum voluntary isometric contraction (MVIC) in a seated position with the knees flexed at 90º |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Pain Scores | from leaving the PACU until 08:00 the morning after surgery | Surgical pain scores both average and worse as collected by nursing staff; and also the average and worse pain during the primary endpoint measurement |
| Sleep Disturbances | recorded at 08:00-09:00 the morning after surgery for the previous night | Total number of times patient woke in the night due to surgical pain. |
| Sensory Effect | 08:00-09:00 morning after surgery | We will evaluate tolerance of transcutaneous electrical stimulation. Electrocardiogram pads will be placed on the plantar and dorsal aspects of the foot, and attached to a nerve stimulator. The current will be increased from 0 mA until subjects described a buzzing sensation (not painful), at which time the current will be recorded as the tolerated level and the nerve stimulator turned off. |
| Anesthetic Leakage | recorded at 08:00-09:00 the morning following Surgery | Leakage from the catheter site noted by patient. |
| analgesic consumption | end of PACU stay until 08:00-09:00 the morning following surgery | Hourly analgesic consumption. |
| Total Infusion | recorded at 08:00-09:00 the morning following Surgery | Total infusiond duration in time and volume and total number of boluses delivered via catheter. |
Countries
United States
Outcome results
None listed