Comparing Subsartorial Saphenous Nerve Blocks With and Without Dexamethasone for Anterior Cruciate Ligament Reconstruction
| Status: | Recruiting |
|---|---|
| Healthy: | No |
| Age Range: | 16 - 65 |
| Updated: | 2/7/2015 |
| Start Date: | July 2012 |
| Contact: | Tzipora Kuba, PhD |
| Email: | kubat@hss.edu |
| Phone: | 212-774-7154 |
Postoperative Analgesia Comparing Subsartorial Saphenous Nerve Block With and Without Dexamethasone in ACL Reconstruction
For patients undergoing Anterior Cruciate Ligament reconstruction surgery, the postoperative
period can be a painful experience without adequate pain management. Hence the investigators
propose a randomized controlled clinical study, investigating prolonged saphenous nerve
blocks. Patients will be randomized to receive saphenous nerve blocks with or without
dexamethasone, a corticosteroid used to prolong analgesia.
Depending on the randomized treatment assignment, patients may receive one of the following:
1. 13 ml of 0.5% bupivacaine, a local anesthetic (no dexamethasone);
2. 13 ml of 0.5% bupivacaine mixed with 1 mg of dexamethasone;
3. 13 ml of 0.5% bupivacaine mixed with 4 mg of dexamethasone.
Patients will be followed postoperatively. Following admission to the recovery room, data
collectors will ask patients to rate their pain on a scale of 0-10 until discharge. Data
collectors will also record patient satisfaction, pain medication use and any side effects
experienced (i.e. nausea and vomiting). Patients will then be contacted on postoperative
days 1, 2 and 14 and asked questions about their general well-being.
period can be a painful experience without adequate pain management. Hence the investigators
propose a randomized controlled clinical study, investigating prolonged saphenous nerve
blocks. Patients will be randomized to receive saphenous nerve blocks with or without
dexamethasone, a corticosteroid used to prolong analgesia.
Depending on the randomized treatment assignment, patients may receive one of the following:
1. 13 ml of 0.5% bupivacaine, a local anesthetic (no dexamethasone);
2. 13 ml of 0.5% bupivacaine mixed with 1 mg of dexamethasone;
3. 13 ml of 0.5% bupivacaine mixed with 4 mg of dexamethasone.
Patients will be followed postoperatively. Following admission to the recovery room, data
collectors will ask patients to rate their pain on a scale of 0-10 until discharge. Data
collectors will also record patient satisfaction, pain medication use and any side effects
experienced (i.e. nausea and vomiting). Patients will then be contacted on postoperative
days 1, 2 and 14 and asked questions about their general well-being.
Inclusion Criteria:
- Patients undergoing ambulatory surgery for anterior cruciate ligament (ACL)
reconstruction with a patella tendon autograft.
- ASA I-III [American Society of Anesthesiologists (ASA) Physical Status classification
system]
- BMI < 35
- Smokers included
- Ages 16-65
Exclusion Criteria:
- Patients on steroids or requiring stress dose steroids
- BMI > 35
- Patient refusal
- Allergy to study medications,
- NRS scores > 3 with frequent opioid use (including tramadol) prior to surgery—daily
for greater than 3 weeks
- Lower extremity neurological dysfunction
- Diabetic (NIDDM, insulin-dependent and/or oral hypoglycemic dependent)
- Not in included age range (under 16 or over 65 years of age)
- Contraindications to the use of dexamethasone
- Non-English speaking patients. We will be using the Short Form 8 Health Survey, as
well as the OR-SDS questionnaire (these are in English; any translations would have
to be separately validated).
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Hospital for Special Surgery Founded in 1863, Hospital for Special Surgery is the nation
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Hospital for Special Surgery Founded in 1863, Hospital for Special Surgery is the nation
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