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Forefoot surgery includes bunion surgery and similar reconstructive bone cutting surgery and is very painful. Local anaesthetic nerve blocks are used to provide pain relief after this work. The purpose of this study is to compare two techniques: one using anatomical landmarks alone to guide local anaesthetic infiltration, the other using peripheral nerve stimulation to guide local anaesthetic infiltration (termed medial forefoot block). The two techniques will be compared for reliability of postoperative analgesia.
More extensive description not desired.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Landmark guided ankle block | Active Comparator | This group will receive a landmark guided ankle block. |
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| This group will be given a PNS guided ankle block | Active Comparator | Peripheral nerve stimulation will be used in this group to guide local anaesthetic infiltration. The technique is termed medial forefoot block. |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Landmark guided ankle block. | Procedure | 25-30mls 0.5% levobupivacaine will be infiltrated to provide a landmark guided ankle block. |
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| Measure | Description | Time Frame |
|---|---|---|
| Efficacy of local anaesthetic block. | The number of patients in each study arm with altered sensation to cold and pin prick, together with no requirement for opiate analgesia, following surgery was recorded. | Over ninety minutes from the start of the study. |
| Measure | Description | Time Frame |
|---|---|---|
| Intravenous opiate usage following surgery | The usage of intravenous morphine, delivered by a ptient controlled analgesia system, in each group was recorded. | 24 hours following surgery |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Andrew J Coe, MbChB FRCA | Hull and East Yorks 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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| ID | Term |
|---|---|
| D006215 | Hallux Valgus |
| ID | Term |
|---|---|
| D005530 | Foot Deformities |
| D009140 | Musculoskeletal Diseases |
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| PNS guided block. | Procedure | This group will have 25-30mls of 0.5% levobupivacaine infiltrated as directed by peripheral nerve stimulation. |
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