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Forefoot surgery includes bunion surgery and similar reconstructive bone cutting surgery and is very painful. Local anaesthetic nerve blocks have been used for many years to help alleviate pain following this surgery. The present study aims to compare a new ultrasound guided nerve block to a well established nerve stimulator guided technique. Comparisons will include time taken to carry out the block, speed of onset of numbness and duration and quality of pain relief after surgery.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Ultrasound guided ankle block | Active Comparator | Subjects in this arm will be given an ultrasound guided ankle block prior to foot surgery. |
|
| Medial forefoot block | Active Comparator | Subjects in this arm will be given a nerve-stimulator guided forefoot block prior to anaesthesia and forefoot surgery |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Ultrasound guided ankle block | Procedure | Under ultrasound guidance, block of the tibial nerve, superficial and deep branches of the common peroneal nerve and saphenous nerves will be carried out using 12 mls 0.5% levobupivacaine and 12 mls 0.75% levobupivacaine. |
| Measure | Description | Time Frame |
|---|---|---|
| Time taken to carry out each local anaesthetic block | Time taken between opening sterile packs and completion of local anaesthetic block is measured by a blind observer. | Over forty five minutes from the start of the study. |
| Measure | Description | Time Frame |
|---|---|---|
| Onset of local anaesthesia | Following administration of the local block, development of anaesthesia will be measured looking at cold and pin-prick sensation by a blind observer. | Over thirty minutes from completion of the local anaesthetic block. |
| Duration of pain relief following local anaesthetic block. |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Andrew J Coe, FRCA | Hull University Teaching Hospitals NHS Trust | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Castle Hill Hospital, Castle Road, Cottingham | Hull | East Yorkshire | HU16 5JQ | United Kingdom |
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| Medial forefoot block | Procedure | Using peripheral nerve stimulator guidance, the tibial and common peroneal nerves will be blocked ( plus the saphenous nerve ), using a total of 12 mls 0.75% levobupivacaine and 12 mls 0.5% levobupivacaine. |
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Pain relief will be assessed over 24 hours following surgery, to assess its duration and quality, by a blind observer. |
| Over 24 hours following surgery. |