Medial Forefoot Block for Analgesia After Foot Surgery

Study Overview
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Brief Summary
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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.

Detailed Description
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More extensive description not desired.

Official Title
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A Randomised, Blinded Comparison of a Nerve Stimulator Guided Ankle Block Compared to a Landmark Guided Ankle Block for Pain Relief After Forefoot Surgery.

Conditions
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Hallux Valgus

Intervention / Treatment
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* Procedure: Landmark guided ankle block.
* Procedure: PNS guided block.


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Fit adults requiring forefoot surgery with bone cutting Exclusion Criteria: Morbid obesity (BMI > 40) Known contraindications to regional anaesthesia

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 85 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: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Double


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Active Comparator: Landmark guided ankle block<br>This group will receive a landmark guided ankle block. | Procedure: Landmark guided ankle block.<br>* 25-30mls 0.5% levobupivacaine will be infiltrated to provide a landmark guided ankle block.<br>* Other names: Other names not required;|
| Active Comparator: This group will be given a PNS guided ankle block<br>Peripheral nerve stimulation will be used in this group to guide local anaesthetic infiltration. The technique is termed medial forefoot block. | Procedure: PNS guided block.<br>* This group will have 25-30mls of 0.5% levobupivacaine infiltrated as directed by peripheral nerve stimulation.<br>* Other names: Other names not required;|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | 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. | 

Secondary Outcome Measures

| Outcome Measure | 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 | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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regional anaesthetic techniques, surgery orthopaedic