Continuous Tibial Nerve Block Versus Single Shot Tibial Nerve Block

Northwestern University

Status: Withdrawn

Conditions: Hallux Valgus

Treatments: Drug: Single injection posterior tibial nerve block; Drug: Posterior tibial nerve catheter

Study type: Interventional

Funder types: Other

Identifiers

NCT01555216

STU00037311

Details and patient eligibility

About

Foot surgery often causes severe and prolonged pain postoperatively. Prior methods of postoperative pain control included oral narcotics, single injection regional techniques and more recently continuous nerve catheters. Recent studies have demonstrated a benefit with continuous popliteal catheters when compared to single injection techniques in regards to postoperative pain control and patient satisfaction for foot surgeries.

Nerve blocks in the popliteal fossa involve both the common peroneal nerve and the tibial nerve. The innervation to the plantar surface of the forefoot involves the tibial nerve and does not involve the peroneal nerve. The purpose of this study is to compare the continuous posterior tibial nerve catheter with a single injection posterior tibial nerve block when used as part of a surgical ankle block for forefoot surgery.

Sex: All

Ages: 18 to 65 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Adult patients (18 to 65 years old) undergoing elective scheduled forefoot surgery (hallux valgus repair and metatarsal osteotomy).

Exclusion criteria

• Patient refusal to be included
• Presence of language barrier that prohibits proper communication with patient
• Under age of 18,
• Pregnancy
• History of allergy to local anesthetics or opioids
• Presence of a progressive neurological deficit
• Chronic opioid or drug abuse
• Diabetes
• Active infection in leg
• Unstable cardiovascular, renal or hepatic disease,
• Unwillingness to comply with follow up.

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Single Group Assignment

Masking: None (Open label)

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0 participants in 2 patient groups

Posterior tibial nerve catheter

Active Comparator group

Description:

5 ml bolus of 0.5% ropivacaine. The catheter will then be connected to a portable pump delivering 3 ml/h of 0.2% ropivacaine with a 2ml bolus every two hours.

Treatment:

Drug: Posterior tibial nerve catheter

Single injection PTNB

Active Comparator group

Description:

Single injection posterior tibial nerve block (PTNB) of 0.5% ropivacaine

Treatment:

Drug: Single injection posterior tibial nerve block