Popliteal Nerve Block for Acute Achilles Tendon Rupture Repair Surgery
Ориентир для пациента и семьи
Простыми словами
Автоматическая сводка по структурированным данным реестра. Она помогает сориентироваться, но не заменяет официальный протокол или оценку врача.
- Что изучают
- В протоколе указаны: Popliteal Nerve Block, Sham Block.
- Кому может быть актуально
- Состояния в реестре: Acute Achilles Tendon Rupture. Базовые параметры: 18 лет — 65 лет · Все.
- Что важно проверить
- Возраст, диагноз и пол — только базовые ориентиры. Предыдущее лечение, анализы и другие обязательные условия указаны ниже в критериях участия.
- Где проводится
- Канада
- Следующий шаг
- Сохраните исследование, покажите его лечащему врачу и уточните актуальный статус у исследовательского центра. Расходы, документы и поездка →
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Официальное название
The Effects of Popliteal Nerve Block on Pain and Nerve-Related Symptoms After Acute Achilles Tendon Rupture Repair Surgery: A Randomized Controlled Trial
Обзор
Achilles tendon rupture is common, yet the value of popliteal nerve block for postoperative pain control during surgical repair remains uncertain. Despite widespread use, evidence supporting its analgesic effectiveness is limited, and both popliteal nerve block and Achilles tendon repair carry risks of nerve injury. This randomized, placebo-controlled trial will evaluate whether adding a popliteal nerve block to standard systemic analgesia improves postoperative pain and reduces opioid use in patients undergoing acute Achilles tendon rupture repair. Secondary outcomes will examine the incidence and impact of nerve complications on recovery, including return to physical activity and functional performance.
Подробное описание
This will be a prospective, double-blinded, randomized controlled superiority trial conducted at Women's College Hospital (WCH). The study aims to enroll 80 patients (40 per group) undergoing ambulatory surgical repair of acute Achilles tendon ruptures.
Вмешательства
- Процедура Popliteal Nerve Block
Under ultrasound guidance, a 22G, 80-mm echogenic needle (SonoTAP II, Pajunk Medical Systems, USA) will be inserted using an in-plane lateral-to-medial approach. 30 mL of 0.5% ropivacaine with 2.5 µg/ml of epinephrine will be deposited between tibial and common peroneal nerves within the paraneural sheath. Adequate spread of local anesthetics will be confirmed by visualization of paraneural spread. - Процедура Sham Block
Patients in the Control group will receive sham blocks using a 25G needle to inject 1 mL of saline subcutaneously in the same location (popliteus of the surgical knee). Sterilization and ultrasound scanning will match actual PN block. Such a non-invasive placebo allows maintaining patient blinding, while reducing the risks associated with high-volume placebo nerve block injections. The ultrasound screen will be blinded from the patient's vision for all patients in the trial to prevent unblinding
Первичные конечные точки
- Cumulative Opioid Consumption [Срок оценки: The first 24 hours after surgery]
Вторичные конечные точки (10)
- Area Under the Curve for Postoperative Pain [Срок оценки: The first 24 hours after surgery]
- Quality of Recovery [Срок оценки: At baseline, 6, 24, 48 hours, 7 days and 1-year post-surgery]
- Postoperative Pain Score [Срок оценки: At baseline, 0, 6, 12, 18, 24, 36, 48 hours, 7 days and 1-year post-surgery.]
- Intraoperative Opioid Consumption [Срок оценки: The first 24 hours after surgery]
- Time to Analgesic Request [Срок оценки: The first 24 hours after surgery]
- Time to Discharge [Срок оценки: The first 24 hours after surgery]
- Adverse Events Attributable to Popliteal Block [Срок оценки: At 0, 6, 12, 18, 24, 36, 48 hours, 7 days and 1-year post-surgery]
- Adverse Events Attributable to Opioids [Срок оценки: Evaluated at 24 and 48 hours after surgery.]
- Pain, fatigue, and physical function [Срок оценки: Prior to surgery and 1-year post-surgery]
- Neuropathic pain [Срок оценки: At 1 week and 1-year post-surgery]
Критерии участия
Критерии включения
- Age 18 - 65
- ASA classification: I - III
- BMI < 35 kg/m2
- Undergoing acute Achilles tendon rupture repair surgery as a day surgery procedure
Критерии исключения
- Pre-existing neurological deficits or peripheral neuropathy in the distribution of the tibial or common peroneal nerves
- Local infection
- Contraindication to regional anesthesia (e.g., bleeding diathesis, coagulopathy)
- History of use of over 30 mg oxycodone or equivalent per day
- Contraindication to any component of a standard multi-modal analgesia
- Allergy to local anesthetics
- History of significant psychiatric conditions that may affect patient assessment
- Pregnancy
- Inability to provide informed consent
- Patient refusal of popliteal nerve blockade
- Prior Achilles tendon surgeries on the operative leg
- Unable to speak or read English
Критерии приведены из реестра в оригинале (на английском). Окончательную оценку соответствия проводит исследовательский центр.
Здоровые добровольцы: Нет
Дизайн исследования
- Распределение
- Рандомизированное
- Модель
- Параллельные группы
- Маскирование
- Тройное слепое
- Основная цель
- Лечение
Центры проведения
Канада · 1 центр
- Women's College Hospital — Toronto
Публикации
- Brenna CTA, Khan S, Abdallah FW, Brull R. Achilles Hero or Heel? A Systematic Review of Popliteal Nerve Block for Achilles Repair. Foot & Ankle Surgery: Techniques, Reports & Cases. 2025:100474.
Идентификаторы
NCT: NCT06886815 · 2025-0039-B