Comparative Efficacy of Sciatic and Femoral Blocks in Ankle Surgery

NCT06758245 | Completed DMC

• 1 other identifier: GAZİOSMANPASATREHTAa
• Study Type: interventional
• Target: 140
• Locations: 1 country
• Sites: 2

Brief Summary

Comparison of Anesthetic and Postoperative Analgesic Efficacy of Femoral and Popliteal Sciatic Block vs Femoral and Anterior Sciatic Block in Ankle Surgery

Conditions

Postoperative Pain Management; Postoperative Pain; Analgesia; Nerve Blocks; Ankle Surgery

Keywords

nerve blocks; ankle surgery; postoperative pain; sciatic block; femoral block

Outcome Measures

Primary Outcomes (1)

• Visual Analogue Scale values

  Visual Analogue Scale is a scale of 0-10 cm in length, expressed by non-standard verbal descriptors (no pain-unbearable pain..) indicating the limits of pain intensity on both sides, horizontally or vertically.

  at 1st, 4th,8th 12th ,24th and 48th hours after the surgery

Secondary Outcomes (1)

• Total amount of opioid requirements

  within 48 hours after the surgery

Study Arms (2)

Femoral-Anterior sciatic block group

ACTIVE COMPARATOR

First, in the supine position, the USG probe is placed below the inguinal crease. The femoral nerve is located lateral to the femoral artery, above the iliopsoas muscle. Once the needle tip reaches the nerve, simultaneous nerve stimulation is applied. Patellar movement is observed due to quadriceps muscle contraction upon needle placement. After a negative aspiration test, 20 ml of local anesthetic is injected.For the anterior sciatic block, while the patient was in the supine position, a convex ultrasound (USG) probe was placed transversely approximately 10 cm distal to the inguinal ligament. After visualizing the sciatic nerve as a hyperechoic flat structure, the nerve stimulator was set to 1-1.5 mA, 0.1 ms, and 1 Hz. Using an in-plane technique, the block needle was advanced. Upon reaching the sciatic nerve, when contractions in the calf, foot, or big toe continued at a current of 0.3-0.5 mA, 20 ml of 0.5% bupivacaine was administered following a negative aspiration test.

Procedure: femoral and anterior sciatic nerve block

Femoral-popliteal sciatic block group

ACTIVE COMPARATOR

First, in the supine position, the USG probe is placed below the inguinal crease. The femoral nerve is located lateral to the femoral artery, above the iliopsoas muscle. Once the needle tip reaches the nerve, simultaneous nerve stimulation is applied. Patellar movement is observed due to quadriceps muscle contraction upon needle placement. After a negative aspiration test, 20 ml of local anesthetic is injected.The ultrasound probe is placed transversely at the popliteal crease. The first structure seen is the popliteal artery. Just above and lateral to the artery, the tibial nerve appears as a hyperechoic, oval, and round structure. After identifying the tibial and peroneal nerves, the probe is moved proximally, and it is observed that the nerves join about 5-10 cm above the popliteal crease. The needle is advanced using an in-plane technique. After obtaining the first sciatic nerve stimulation, 20 cc of 0.5% bupivacaine is injected following a negative aspiration test.

Procedure: femoral and popliteal sciatic nerve block

Interventions

femoral and anterior sciatic nerve block PROCEDURE

First, in the supine position, the USG probe is placed below the inguinal crease. The femoral nerve is located lateral to the femoral artery, above the iliopsoas muscle. Once the needle tip reaches the nerve, simultaneous nerve stimulation is applied. Patellar movement is observed due to quadriceps muscle contraction upon needle placement. After a negative aspiration test, 20 ml of local anesthetic is injected.For the anterior sciatic block, while the patient was in the supine position, a convex ultrasound (USG) probe was placed transversely approximately 10 cm distal to the inguinal ligament. After visualizing the sciatic nerve as a hyperechoic flat structure, the nerve stimulator was set to 1-1.5 mA, 0.1 ms, and 1 Hz. Using an in-plane technique, the block needle was advanced. Upon reaching the sciatic nerve, when contractions in the calf, foot, or big toe continued at a current of 0.3-0.5 mA, 20 ml of 0.5% bupivacaine was administered following a negative aspiration test.

Femoral-Anterior sciatic block group

femoral and popliteal sciatic nerve block PROCEDURE

The ultrasound probe is placed transversely at the popliteal crease. The first structure seen is the popliteal artery. Just above and lateral to the artery, the tibial nerve appears as a hyperechoic, oval, and round structure. After identifying the tibial and peroneal nerves, the probe is moved proximally, and it is observed that the nerves join about 5-10 cm above the popliteal crease. The needle is advanced using an in-plane technique. After obtaining the first sciatic nerve stimulation, 20 cc of 0.5% bupivacaine is injected following a negative aspiration test.

Femoral-popliteal sciatic block group

Eligibility Criteria

• Age: 18 Years - 65 Years
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• years of age
• American Society of Anesthesiologists physical statusⅠ-II

You may not qualify if:

• Pregnant
• Neuromuscular disease
• Peripheral neuropathy
• Coagulation disorders
• Allergy to local anesthetics
• Infection at the site where the nerve block will be applied

Sponsors & Collaborators

• Gaziosmanpasa Research and Education Hospital: lead

Study Sites (2)

Gaziosmanpasa Training and Research Hospital, Istanbul, 34000

Istanbul, Gaziosmanpasa, 34255, Turkey (Türkiye)

Location

Gaziosmanpasa Training and Research Hospital

Istanbul, Turkey (Türkiye)

Location

Related Publications (1)

• Olofsson M, Nguyen A, Rossel JB, Albrecht E. Duration of analgesia after forefoot surgery compared between an ankle and a sciatic nerve block at the popliteal crease: A randomised controlled single-blinded trial. Eur J Anaesthesiol. 2024 Jan 1;41(1):55-60. doi: 10.1097/EJA.0000000000001929. Epub 2023 Nov 16.

  PMID: 37972929 BACKGROUND

MeSH Terms

Conditions

Pain, Postoperative; Agnosia

Condition Hierarchy (Ancestors)

Postoperative Complications; Pathologic Processes; Pathological Conditions, Signs and Symptoms; Pain; Neurologic Manifestations; Signs and Symptoms; Perceptual Disorders; Neurobehavioral Manifestations; Nervous System Diseases

Study Officials

• Döndü GENÇ MORALAR, MD

  GAZİOSMANPAŞA RESEARCH AND TRAİNİNG HOSPİTAL

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: DOUBLE
• Who Masked: PARTICIPANT, CARE PROVIDER
• Purpose: SUPPORTIVE CARE
• Intervention Model: PARALLEL
• Sponsor Type: OTHER GOV
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: principal investigator

Study Record Dates

• First Submitted: December 26, 2024
• First Posted: January 3, 2025
• Study Start: November 24, 2023
• Primary Completion: July 1, 2024
• Study Completion: July 1, 2024
• Last Updated: August 28, 2025

Record last verified: 2025-08

Locations

TU (2)