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Current practices when performing any peripheral nerve block may or may not involve ensuring circumferential spread of local anesthetic around the nerve. Ensuring circumferential spread can involve several redirections of the needle above and below the nerve, and potentially could result in either more discomfort for the patient or an increased chance of inadvertent direct trauma to the nerve. Not ensuring spread around the nerve may result in a slower and less complete blockade. The investigators suspect that by ensuring complete spread around the nerve, the speed of block onset would be quicker because it avoids the loss due to diffusion time.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| 1 | Experimental | Ensuring circumferential spread of local anesthetic around the sciatic nerve. |
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| 2 | Active Comparator | Single shot injection of local anesthetic near the sciatic nerve will be performed, without ensuring circumferential spread. |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Circumferential spread of local anesthetic | Procedure | The anesthetist will ensure, under ultrasound guidance, that local anesthetic (1 mL of 1% lidocaine) surrounds the sciatic nerve. |
| Measure | Description | Time Frame |
|---|---|---|
| Onset time of sciatic nerve blockade. | Every 5 minutes for 30 minutes after anesthetic injection |
| Measure | Description | Time Frame |
|---|---|---|
| Block success, time required to perform block, complications/adverse events, number of needle passes, patient discomfort | 24 hours |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Richard Brull, MD | University Health Network, Toronto | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Toronto Western Hospital | Toronto | Ontario | M5W 2S8 | Canada |
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| Non-circumferential spread of local anesthetic | Procedure | The anesthetist will perform a "single shot" injection of local anesthetic (1 mL of 1% lidocaine) near the sciatic nerve under ultrasound guidance, without ensuring circumferential spread around the nerve. |
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