Abstract PR510

Abstract

Background & Objectives: A popliteal nerve block is frequently used for postoperative pain management after orthopaedic foot surgery. Popliteal nerve block may provide superior pain relief compared to systemic analgesic therapy, which is often accompanied by side effects of medication prescribed. Unfortunately, the analgesic effect is limited to the first hours after surgery, after which additional analgesic therapy is often required. In this study, we assessed the ability of clonidine as an additive to local anaesthetics to prolong the analgesic effect of popliteal nerve block. Materials & Methods: Patients scheduled for orthopaedic foot surgery (all osteotomies) were included in this randomized double-blind study. After informed consent, patients were randomized into a control or intervention group. Both groups received a popliteal nerve block with 30 cc levobupivacaine 5 mg/ml, in the intervention group clonidine 105 ugr was added to the local anaesthetic. All blocks were performed with ultrasound guidance and neurostimulation. After popliteal nerve block, patients received spinal or general anaesthesia. The primary endpoint of this study was the First Analgesic Request (FAR), the time after which additional pain medication was requested. Secondary endpoints were pain intensity, side effects, occurrence of hypotension or bradycardia. Results: From August 2015 until December 2015, 68 patients were included. After analysis 7 patients were excluded because of failed block (N=6) and not following study protocol (N= 1). Fifty-one patients were female (84%) and the mean age was 51,8 years. All participants had ASA physical status I/II. Eighty-two percent received general anaesthesia with the rest receiving spinal anaesthesia. The median FAR (interquartile range) was 1320 (326) minutes and 1280 (245) minutes in the intervention and control group, respectively (p=0.44; figure). The secondary endpoints pain intensity, frequency of side effects, hypotension and bradycardia did not significantly differ between the study groups.Conclusion: The use of clonidine as an additive to levobupivacaine for popliteal nerve block did not result in a significant difference in the duration of postoperative analgesia in orthopaedic foot surgery. Disclosure of Interest: None declared