Continuous Popliteal Nerve Blocks: Effect of Perineural Catheter Tip Location Relative to the Sciatic Nerve Bifurcation on Postoperative Analgesia

Study Overview
=================
Brief Summary
-----------------
Research study to determine the relationship between perineural catheter tip location relative to the sciatic nerve bifurcation and postoperative analgesia for continuous popliteal nerve blocks.

Detailed Description
-----------------
Hypothesis: During a continuous popliteal nerve block, postoperative analgesia will be improved with the perineural catheter tip at the level of the sciatic nerve bifurcation compared to when the catheter tip is 5 cm cephalad/proximal to the bifurcation.

Official Title
-----------------
Continuous Popliteal Nerve Blocks: Effect of Perineural Catheter Tip Location Relative to the Sciatic Nerve Bifurcation on Postoperative Analgesia

Conditions
-----------------
Popliteal Nerve Block, Foot Surgery, Ankle Surgery, Popliteal Bifurcation

Intervention / Treatment
-----------------
* Procedure: Catheter Placed At Bifurcation
* Procedure: Catheter Placed 5cm Above Bifurcation


Participation Criteria
=================
Eligibility Criteria
-----------------
Inclusion Criteria: undergoing surgery with a popliteal perineural catheter for postoperative analgesia age 18 years or older Exclusion Criteria: pregnancy inability to communicate with the investigators and hospital staff incarceration clinical neuropathy in the surgical extremity chronic high-dose opioid use a history of opioid abuse surgery outside of ipsilateral sciatic and saphenous nerve distributions

Ages Eligible for Study
-----------------
Minimum Age: 18 Years

Sexes Eligible for Study
-----------------
All

Accepts Healthy Volunteers
-----------------
No

Study Plan
=================
How is the study designed?
-----------------

Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Active Comparator: At Bifurcation<br>Patients randomized to this group will receive a sciatic nerve block placed at the bifurcaton of the sciatic nerve and outcome measures will be tested. | Procedure: Catheter Placed At Bifurcation<br>* Patients randomized to this group will receive a sciatic nerve block placed at the bifurcaton of the sciatic nerve and outcome measures will be tested.<br>|
| Active Comparator: 5cm Above Bifurcation<br>Patients randomized to this group will receive a sciatic nerve block placed 5cm above the bifurcaton of the sciatic nerve and outcome measures will be tested. | Procedure: Catheter Placed 5cm Above Bifurcation<br>* Patients randomized to this group will receive a sciatic nerve block placed 5cm above the bifurcaton of the sciatic nerve and outcome measures will be tested.<br>|

What is the study measuring?
-----------------
Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Average Pain | The average pain in the three hours previous to a phone call the day following surgery as measured on a numeric rating scale (0-10, 0=no pain, 10=worst imaginable pain). | 1 Day following surgery | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Analgesic Use | Total oral opioid use since surgery and total IV analgesics if any. | 1 day following surgery | 
| Sleep Disturbances | Total number of times patient woke due to pain the night following surgery. | 1 day following surgery | 
| Infusion Side Effects | Numbness of foot and toes on a 0-10 scale where 0=no numbness and 10=complete numbness. | 1 day following surgery | 
| Satisfaction of pain control | Patients will give an answer on a 0-10 scale where 0=completely unsatisfied wiht pain control and 10=completely satisfied with pain control. | 1 day following surgery | 

 Terms related to the study
=================
Keywords Provided by Centre Hospitalier Valida
-----------------
Popliteal, UCSD, Postoperative pain, Foot surgery, Ankle surgery, Popliteal Catheter, Popliteal Nerve Block, Lower extremity surgery, Bifurcation, Catheter Insertion Site