Conditions: Patients Undergoing Ankle Surgery
Keywords: Analgesia Duration Popliteal Fossa Nerve Block Dexamethasone Buprenorphine Additives Ankle surgery
Allocation: RANDOMIZED | Intervention model: PARALLEL
Enrollment: 108
Healthy volunteers: no

Brief summary:
Patients scheduled to go home after ankle surgery at HSS typically receive a sciatic nerve block in the popliteal fossa and oral analgesic tablets (such as Percocet). Popliteal fossa nerve blockade has reduced pain for these patients (YaDeau et al, Anesth Analg 2008;106:1916-20), but unfortunately the patients still often experience moderate to severe pain after the block wears off. The investigators wish to study two additives that may prolong the period of analgesia provided by the nerve block. The additives will be studied in the context of a standardized postoperative multimodal analgesic pathway.

Primary outcome:

Does adding dexamethasone and / or buprenorphine prolong the analgesia provided by a popliteal fossa nerve block?

Detailed description:

Arms:
arm 1: Control Nerve Block. IV Dexamethasone (4 mg). arm 2: B. Nerve Block with Dexamethasone (4 mg). IV saline. arm 3: Control Nerve Block. IV Dexamethasone (4 mg). IV Buprenorphine (0.3 mg) arm 4: Nerve Block with Buprenorphine (0.3 mg). IV Dexamethasone (4 mg). arm 5: Nerve Block with Dexamethasone (4 mg) / block Buprenorphine (0.3 mg). IV saline.

Interventions: intervention 1: A. Control Nerve Block. IV Dexamethasone (4 mg). intervention 2: B. Nerve Block with Dexamethasone (4 mg). IV saline. intervention 3: C. Control Nerve Block. IV Dexamethasone (4 mg). IV Buprenorphine (0.3 mg) intervention 4: D. Nerve Block with Buprenorphine (0.3 mg). IV Dexamethasone (4 mg). intervention 5: E. Nerve Block with Dexamethasone (4 mg) / block Buprenorphine (0.3 mg).
Intervention descriptions: intervention 1: A. Control Nerve Block. IV Dexamethasone (4 mg). intervention 2: B. Nerve Block with Dexamethasone (4 mg). IV saline. intervention 3: C. Control Nerve Block. IV Dexamethasone (4 mg). IV Buprenorphine (0.3 mg) intervention 4: D. Nerve Block with Buprenorphine (0.3 mg). IV Dexamethasone (4 mg). intervention 5: E. Nerve Block with Dexamethasone (4 mg) / block Buprenorphine (0.3 mg). IV saline.

Protocol document: