Ankle Surgery, Foot Surgery, Popliteal Nerve Block
Conditions
Brief summary
With the increasing rise of outpatient surgery in orthopaedic procedures, the management of immediate postoperative pain has been a major topic investigated, with the use of a peripheral nerve block in combination with general anesthesia being a commonly accepted method. Foot and ankle procedures, which offer the choice of several anesthetic techniques, have increasingly been performed with this method predominantly through the combination of general anesthesia with a single-injection popliteal nerve block to reduce the substantial acute postoperative pain that often requires large opioid intake within the post-anesthesia care unit (PACU). However, as a single-injection peripheral nerve block resolves off shortly following surgery, major postoperative pain, termed rebound pain, can also arise, and has the potential to be even greater than that of patients who do not receive any peripheral nerve block with general anesthesia. The purpose of this study is to evaluate the contribution of ropivacaine concentration (0.5% versus 0.25%) of the initial bolus in continuous popliteal nerve blocks toward the rebound pain phenomena, or the quantifiable difference in pain experienced during the initial time after block resolution, in foot and ankle surgeries.
Interventions
DRUGRopivacaine 0.5% Injectable Solution
Participants will receive the nerve block preoperatively using 0.5% ropivacaine
DRUGRopivacaine 0.25% Injectable Solution
Participants will receive the nerve block preoperatively using 0.25% ropivacaine
DRUGPercocet Pill
After surgery participants will be given a prescription for Percocet to be taken as needed for pain
DRUGNorco Pill
After surgery participants will be given a prescription for Norco to be taken as needed for pain
PROCEDUREFoot/Ankle Surgery
Participant will undergo foot or ankle surgery and receive a popliteal nerve block
Sponsors
Rothman Institute Orthopaedics
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
Yes
Inclusion criteria
* All patients undergoing foot and ankle surgeries under the care of Dr. Steven Raikin with continuous popliteal blocks at Riverview Surgical Center will be considered for enrollment.
Exclusion criteria
* Patients who present with a) known hypersensitivity to ropivacaine or to any local anesthetic agent of the amide type, * Existing use of narcotics, * Pregnant women, * Individuals under the age of 18 * Procedures involving any other forms of anesthesia other than general anesthesia with a continuous popliteal nerve block.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Postoperative Pain | 7 days | Participants Satisfaction with pain control will be measured using the Visual Analog Scale for Pain (VAS) |
| Postoperative Opioid Usage | 7 days | For each group, participants will be asked to record their postoperative pain medication usage daily |
Countries
United States
Outcome results
None listed