Popliteal Nerve Block for Achilles Tendon Repair

Overseen By Connor T.A. Brenna, MD

Age: 18+

Sex: Any

Travel: May Be Covered

Time Reimbursement: Varies

Trial Phase: Academic

Waitlist Available

Sponsor: University of Toronto

No Placebo Group

Trial Summary

What is the purpose of this trial?

Surgery has traditionally been the mainstay of treatment for patients who experience acute Achilles tendon rupture, and anesthesia for this operation often includes a popliteal nerve block. However, the evidence basis for this practice is uncertain, and popliteal nerve block has associated risks such as peripheral nerve injury. This research study will evaluate the effects of popliteal nerve block on postoperative pain, recovery, and quality of life after Achilles tendon repair surgery, in order to better inform patient and provider decisions to receive or perform popliteal nerve block for this operation.

Research Team

Richard Brull, MD FRCPC

Principal Investigator

University Health Network, Toronto

Eligibility Criteria

This trial is for patients undergoing Achilles tendon repair surgery. Participants should be suitable for caudal epidural block therapy or regional anesthesia. Those with a ruptured corpus cavernosum are excluded, ensuring the focus remains on individuals specifically dealing with Achilles tendon issues.

Inclusion Criteria

BMI < 35 kg/m2

I am between 18 and 65 years old.

My health is good to moderately impaired.

Exclusion Criteria

History of use of over 30 mg oxycodone or equivalent per day

History of significant psychiatric conditions that may affect patient assessment

Pregnancy

Treatment Details

Interventions

• Popliteal Nerve Block (Local Anesthetic)

Trial Overview The study tests the effectiveness of popliteal nerve blocks in managing postoperative pain and aiding recovery after Achilles tendon repair surgery. It compares real popliteal nerve blocks against sham blocks (placebos) to assess their impact on patient outcomes.

Participant Groups

Group I: Popliteal Nerve Block Group Experimental Treatment 1 Intervention

Patients will be randomly assigned to this, or a comparator, group. In accordance with routine pre-block management, non-invasive blood pressure, electrocardiogram, and pulse oximeter will be attached to the patient. A 20G intravenous access will be secured in the upper extremity to begin administering an intravenous infusion of Lactated Ringer's solution. Prior to block performance, all patients will receive intravenous midazolam 1 - 4 mg IV for anxiolysis. In a designated block room, a regional anesthesiologist or anesthesia fellow with experience performing popliteal nerve blocks will sterilize the popliteus of the surgical knee with 2% chlorhexidine swabs, infiltrate it with 2 mL 2% lidocaine, and visualize the underlying anatomy using ultrasound. They will then perform a popliteal nerve block for patients in this group. Patients in both groups will otherwise receive identical preoperative and postoperative care.

Group II: Control Group Placebo Group 1 Intervention

Patients will be randomly assigned to this, or an intervention, group. In accordance with routine pre-block management, non-invasive blood pressure, electrocardiogram, and pulse oximeter will be attached to the patient. A 20G intravenous access will be secured in the upper extremity to begin administering an intravenous infusion of Lactated Ringer's solution. Prior to block performance, all patients will receive intravenous midazolam 1 - 4 mg IV for anxiolysis. In a designated block room, a regional anesthesiologist or anesthesia fellow with experience performing popliteal nerve blocks will sterilize the popliteus of the surgical knee with 2% chlorhexidine swabs, infiltrate it with 2 mL 2% lidocaine, and visualize the underlying anatomy using ultrasound. They will then perform a sham block for patients in this group. Patients in both groups will otherwise receive identical preoperative and postoperative care.

Who Is Running the Clinical Trial?

University of Toronto

Lead Sponsor

Trials

739

Recruited

1,125,000+