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Surgeon doing procedures amenable to this study left institution.
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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.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Subgluteal Sciatic Nerve Block | Active Comparator | 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. |
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| Popliteal Sciatic Nerve Block | Active Comparator | 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. |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Subgluteal Sciatic Nerve Block | Procedure | 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. |
| Measure | Description | Time Frame |
|---|---|---|
| Muscle Strength (MVIC) of the hamstring muscles | 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 | 08:00-09:00 morning after surgery as a percentage of baseline |
| Measure | Description | Time Frame |
|---|---|---|
| Sensory Effect | 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. |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Brian M Ilfeld, M.D., M.S. | University of California, Department of Anesthesiology | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| UCSD Medical Center, Thornton | La Jolla | California | United States | |||
| UCSD Medical Center Hillcrest |
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| ID | Term |
|---|---|
| D010146 | Pain |
| ID | Term |
|---|---|
| D009461 | Neurologic Manifestations |
| D012816 | Signs and Symptoms |
| D013568 | Pathological Conditions, Signs and Symptoms |
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| Popliteal Sciatic Nerve Block | Procedure | 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. |
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| 08:00-09:00 morning after surgery |
| Pain Scores | Surgical pain scores both average and worse as collected by nursing staff; and also the average and worse pain during the primary endpoint measurement | from leaving the PACU until 08:00 the morning after surgery |
| Sleep Disturbances | Total number of times patient woke in the night due to surgical pain. | recorded at 08:00-09:00 the morning after surgery for the previous night |
| Total Infusion | Total infusiond duration in time and volume and total number of boluses delivered via catheter. | recorded at 08:00-09:00 the morning following Surgery |
| Anesthetic Leakage | Leakage from the catheter site noted by patient. | recorded at 08:00-09:00 the morning following Surgery |
| analgesic consumption | Hourly analgesic consumption. | end of PACU stay until 08:00-09:00 the morning following surgery |
| San Diego |
| California |
| 92103 |
| United States |