Continuous Femoral Nerve Block With a Tibial Plateau Fracture
| Status: | Completed |
|---|---|
| Conditions: | Orthopedic |
| Therapuetic Areas: | Orthopedics / Podiatry |
| Healthy: | No |
| Age Range: | 18 - Any |
| Updated: | 4/21/2016 |
| Start Date: | February 2013 |
| End Date: | December 2014 |
Postoperative Pain Management With a Continuous Femoral Nerve Block in Patients With a Tibial Plateau Fracture
The primary purpose of the proposed study is to compare postoperative pain scores and total
opioid consumption between two groups randomized to either receive or not receive a femoral
nerve block for pain control following surgical repair of a tibial plateau fracture. Pain
will be assessed post-operatively using standard numeric pain scores rated on a 0 - 10
scale, as well as using the University new pain assessment tool - the Clinically Aligned
Pain Assessment (CAPA). This new 5 question pain assessment tool has not yet been validated,
but does address several key questions, including patient comfort, pain control, change in
pain status, daily functioning, and sleep quality. Along with post-operative pain scores, we
will compare total opioid consumption between the two groups.
The null hypothesis is that there is no difference in pain scores or total opioid
consumption between patients receiving a femoral nerve block and those without a nerve block
following surgical repair of a tibial plateau fracture.
A secondary outcome will examine long-term pain control, range of motion, and functional
status of these patients at their regular orthopedic clinic follow-up appointments. The same
pain scores will be assessed, along with quadriceps strength and knee range of motion.
Patients will complete the PROMIS Physical Function CAT and short Musculoskeletal Function
Assessment, patient reported outcomes tools to evalute physical function.
A teriary outcome will be to retrospectively examine postoperative pain scores and total
opioid consumption for all tibial plateau fracture patients seen at the University of Utah
for surgical repair in the past 10 years.
opioid consumption between two groups randomized to either receive or not receive a femoral
nerve block for pain control following surgical repair of a tibial plateau fracture. Pain
will be assessed post-operatively using standard numeric pain scores rated on a 0 - 10
scale, as well as using the University new pain assessment tool - the Clinically Aligned
Pain Assessment (CAPA). This new 5 question pain assessment tool has not yet been validated,
but does address several key questions, including patient comfort, pain control, change in
pain status, daily functioning, and sleep quality. Along with post-operative pain scores, we
will compare total opioid consumption between the two groups.
The null hypothesis is that there is no difference in pain scores or total opioid
consumption between patients receiving a femoral nerve block and those without a nerve block
following surgical repair of a tibial plateau fracture.
A secondary outcome will examine long-term pain control, range of motion, and functional
status of these patients at their regular orthopedic clinic follow-up appointments. The same
pain scores will be assessed, along with quadriceps strength and knee range of motion.
Patients will complete the PROMIS Physical Function CAT and short Musculoskeletal Function
Assessment, patient reported outcomes tools to evalute physical function.
A teriary outcome will be to retrospectively examine postoperative pain scores and total
opioid consumption for all tibial plateau fracture patients seen at the University of Utah
for surgical repair in the past 10 years.
Inclusion Criteria:
- Male and female patients, aged 18 years or older, who are presenting to the
University Hospital for surgical repair of a tibial plateau fracture will be
considered for inclusion in the prospective study. The diagnosis of a tibial plateau
fracture and the decision to proceed to the operating room for surgery will be made
by the attending surgeon of the orthopedic trauma service based on his expertise and
standard of care.
- Male and female patients, aged 18 years or older, who have underwent surgery
performed by Dr. Kubiak or Dr. Higgins at University Hospital for repair of a tibial
plateau fracture will be considered for inclusion in the retrospective study.
Exclusion Criteria:
Prospective Study:
- Patients who do not speak English
- Patients who are unable to effectively communicate with their treatment team
(example: mechanically ventilated patients and mentally handicapped patients)
- Patients less than 18 years old
- Patients with ongoing compartment syndrome
- Patients with an allergy or intolerance to bupivacaine
- Patients with other significant associated traumatic injuries that would be expected
to delay their overall recovery (example: a patient who sustains a motor vehicle
accident and fractures their tibia but also sustains massive intra-abdominal injury
with serious damage to their liver and other vital organs)
- Patients with ipsilateral femoral fractures
Retrospective:
- Patients less than 18 years of age
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