The Importance of the Saphenous Nerve Block for Analgesia Following Major Ankle Surgery:A Randomized, Controlled, Double-Blind Study
| Autor: | Rasmus W. Hauritz, Siska Bjørn, Thomas Fichtner Bendtsen, Jens Børglum, Wan Yi Wong, Kristian K. Nielsen, Jorgen Baas |
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| Jazyk: | angličtina |
| Rok vydání: | 2018 |
| Předmět: |
Male
medicine.medical_specialty Nerve Block/methods medicine.medical_treatment 03 medical and health sciences 0302 clinical medicine Double-Blind Method 030202 anesthesiology medicine Pain Postoperative/diagnostic imaging Humans Clinical significance Prospective Studies Anesthetics Local Prospective cohort study Saline Pain Measurement Aged Bupivacaine Pain Postoperative business.industry Anesthetics Local/administration & dosage Nerve Block General Medicine Middle Aged Surgery Clinical trial Saphenous nerve Anesthesiology and Pain Medicine medicine.anatomical_structure Nerve block Ankle/diagnostic imaging Female Analgesia/methods Analgesia Ankle Bupivacaine/administration & dosage business Pain Measurement/drug effects 030217 neurology & neurosurgery medicine.drug |
| Zdroj: | Bjørn, S, Wong, W Y, Baas, J, Nielsen, K K, Børglum, J, Hauritz, R W & Bendtsen, T F 2018, ' The Importance of the Saphenous Nerve Block for Analgesia Following Major Ankle Surgery : A Randomized, Controlled, Double-Blind Study ', Regional Anesthesia and Pain Medicine, vol. 43, no. 5, pp. 474-479 . https://doi.org/10.1097/AAP.0000000000000764 |
| ISSN: | 0269-7955 |
| DOI: | 10.1097/AAP.0000000000000764 |
| Popis: | BACKGROUND AND OBJECTIVES: Major ankle surgery causes intense postoperative pain, and whereas the importance of a sciatic nerve block is well established, the clinical significance of a supplemental saphenous nerve block has never been determined in a prospective, randomized, double-blind, placebo-controlled trial. We hypothesized that a saphenous nerve block reduces the proportion of patients experiencing significant clinical pain after major ankle surgery.METHODS: Eighteen patients were enrolled and received a popliteal sciatic nerve block. Patients were randomized to single-injection saphenous nerve block with 10 mL 0.5% bupivacaine with 1:200,000 epinephrine or 10 mL saline (Fig. 1). Primary outcome was the proportion of patients reporting significant clinical pain, defined as a score greater than 3 on the numerical rating scale. Secondary outcomes were maximal pain and analgesia of the cutaneous territory of the infrapatellar branch of the saphenous nerve.RESULTS: Eight of 9 patients in the placebo group reported significant clinical pain versus 1 of 9 patients in the bupivacaine-epinephrine group (P = 0.003). Maximal pain was significantly lower in the active compared with the placebo group (median, 0 [0-0] vs 5 [4-6]; P = 0.001). Breakthrough pain from the saphenous territory began within 30 minutes after surgery in all cases. Sensory testing of the cutaneous territory of the infrapatellar branch of the saphenous nerve showed correlation between pain reported in the anteromedial ankle region and the intensity of cutaneous sensory block in the anteromedial knee region.CONCLUSIONS: The saphenous nerve is an important contributor to postoperative pain after major ankle surgery, with significant clinical pain appearing within 30 minutes after surgery.CLINICAL TRIALS REGISTRATION: This study has been registered at ClinicalTrials.gov, identifier NCT02697955. |
| Databáze: | OpenAIRE |
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