Institutional Review Board, Hospital for Special Surgery
May 24, 2012
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Mary F. Chisholm, MD
For patients undergoing ACL reconstruction surgery, the postoperative period can be a painful experience without adequate pain management. Hence we 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) local anesthetic with 2 ml of saline (no dexamethasone);
2) local anesthetic mixed with 2 mg of dexamethasone;
3) local anesthetic 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.
- All ASA I-III patients undergoing ambulatory surgery for ACL reconstruction with a patella tendon autograft.
- 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)
- Under 16 years of age and over 65 years of age
- Contraindications to the use of dexamethasone
- Non-English speaking patients (questionnaires to be used have been validated in English only thus far)