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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.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Standard Popliteal Nerve Block | Active Comparator | Participants undergoing foot or ankle surgery will receive an initial injection of 0.5% ropivacaine as the initial anesthetic followed by continuous injection of 0.25% ropivacaine. |
|
| Partial Popliteal Nerve Block | Active Comparator | Participants undergoing foot or ankle surgery will receive 0.25% ropivacaine initially followed by the usual continuous injection of 0.25% ropivacaine during surgery |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Ropivacaine 0.5% Injectable Solution | Drug | Participants will receive the nerve block preoperatively using 0.5% ropivacaine |
|
| Measure | Description | Time Frame |
|---|---|---|
| Postoperative Pain | Participants Satisfaction with pain control will be measured using the Visual Analog Scale for Pain (VAS) | 7 days |
| Postoperative Opioid Usage | For each group, participants will be asked to record their postoperative pain medication usage daily | 7 days |
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Inclusion Criteria:
Exclusion Criteria:
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Rothman Orthopaedic Institute | Philadelphia | Pennsylvania | 19107 | United States |
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| Ropivacaine 0.25% Injectable Solution | Drug | Participants will receive the nerve block preoperatively using 0.25% ropivacaine |
|
| Percocet Pill | Drug | After surgery participants will be given a prescription for Percocet to be taken as needed for pain |
|
| Norco Pill | Drug | After surgery participants will be given a prescription for Norco to be taken as needed for pain |
|
| Foot/Ankle Surgery | Procedure | Participant will undergo foot or ankle surgery and receive a popliteal nerve block |
|
| ID | Term |
|---|---|
| D000077212 | Ropivacaine |
| C514822 | oxycodone-acetaminophen |
| ID | Term |
|---|---|
| D000813 | Anilides |
| D000577 | Amides |
| D009930 | Organic Chemicals |
| D000814 | Aniline Compounds |
| D000588 | Amines |
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