The Influence of Peripheral Nerve Blocks in Patients Undergoing Limb Orthopedic Surgery

Study Overview
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Brief Summary
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To investigate pre-op peripheral nerve block in reducing peri-op IL-6 level and post-op pain

Detailed Description
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In orthopedic surgery, peripheral nerve block can be used as an anesthesia adjuvant prior to surgery. In this study, we hypothesized that peripheral nerve blocks may alleviate inflammatory response and reduce the analgesics requirement. Sixty patients undergoing limb orthopedic surgery will be enrolled. Peripheral nerve block was injected with 0.25% bupivacaine under ultrasound guidance. 30 patients (Study group) underwent surgery with nerve blocks and another 30 patients (Control group) underwent surgery with morphine. The anesthetic protocol was standardized for both groups by experienced anesthesiologists. Surgical stress was assessed by blood pressure fluctuation and proinflammatory cytokine. Pain intensity was measured by numeric rating scale (NRS) score for 24 hours

Official Title
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Preoperative Peripheral Nerve Blocks Attenuate Intraoperative Surgical Stress and Postoperative Pain in Patients Undergoing Orthopedic Surgery

Conditions
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Pain, Postoperative, Change; Circulatory, Surgical Injury

Intervention / Treatment
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* Procedure: 0.25% bupivacaine


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: diagnosis of limb fracture must receiving orthopedic surgery Exclusion Criteria: With the comorbidity of chronic heart, lung, liver and renal disease, Chronic alcoholism, Allergy to bupivacaine

Ages Eligible for Study
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Minimum Age: 20 Years
Maximum Age: 80 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Health Services Research
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Active Comparator: Nerve block(+)<br>patient accept nerve block for post-op pain control | Procedure: 0.25% bupivacaine<br>* nerve block procedure will be decided by patients' will for post-op pain<br>* Other names: nerve block with 0.25% bupivacaine;|
| Sham Comparator: Morphine<br>patient received morphine for post-op pain control | Procedure: 0.25% bupivacaine<br>* nerve block procedure will be decided by patients' will for post-op pain<br>* Other names: nerve block with 0.25% bupivacaine;|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| peak pain intensity in the postoperative care unit | pain score evaluated by pain score | 2 hours | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| change of perioperative IL-6 level | blood samples assessed by ELISA | up to 6 hours | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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peripheral nerve block, IL-6, post-operative pain, limb surgery