Anesthesia, Local Clinical Trial
Official title:
Double-blinded Randomised Controlled Trial (RCT) Comparing a High Ankle Block to Placebo in Patients Treated for Ankle Pathologies
The aim of the herein presented double-blinded is to compare the effectiveness of the high
foot block against placebo infiltration in simple, uni- and bimalleolar ankle fractures.
Included will be all adult patients (>18a) treated surgically at our department. The standard
peri-operative procedure at our clinic will no be altered but the additional high ankle
block. The intraoperative opioid requirement, the Visual Analogue Scale for Pain (VAS) and
the postoperative opioid requirement will be assessed and compared between the two groups
Ankle fractures were among the most common injuries of the lower extremity. Peri-operative,
multimodal pain therapy is of great importance in the surgical treatment of those injuries.
Whereas simple (uni- and bimalleolar) ankle fractures are covered peri-operatively by oral
pain medication and Piritramid-PCA (PCA=Patient-controlled analgesia), complex, trimalleolar
fractures usually receive additional regional pain catheters (femoralis blockade and
ischiadicus blockade).
Regional pain catheters have the major downside of motor paresis and are therefore critically
discussed. Various studies have explored new techniques for perioperative pain therapy. An
established procedure in midfoot and forefoot surgery is the foot block. It can be inserted
at different heights around the ankle joint. However, the effectiveness of the high foot
block has not yet been investigated for ankle fractures. The aim of the herein presented
double-blinded is to compare the effectiveness of the high foot block against placebo
infiltration in simple, uni- and bimalleolar ankle fractures.
All patients who are operated on in our department due to a uni- or bimalleolar ankle
fracture, who are over 18 years of age and have no serious pre-existing conditions or
contraindications to local anaesthesia (LA) are eligible for inclusion.
The perioperative procedure does not change to the current treatment standard at the
University Hospital Munich - Ludwig Maximilians University (LMU) except for randomization for
high foot block or placebo. Both the anesthesia and the postoperative pain therapy correspond
to the current treatment standard and are the same for both groups. The intraoperative opioid
requirement, the VAS and the postoperative opioid requirement will be assessed.
The data is collected using the RedCap database (#19-177), which has already been reviewed by
the ethics committee. The evaluation will be performed using SPSS 25.0 (IBM).
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