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Trial registered on ANZCTR
Registration number
ACTRN12611001166965
Ethics application status
Approved
Date submitted
5/11/2011
Date registered
8/11/2011
Date last updated
14/08/2012
Type of registration
Prospectively registered
Titles & IDs
Public title
Comparison of dexamethasone route of administration on ankle block duration and analgesia for foot and ankle surgery
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Scientific title
Comparison of dexamethasone route of administration on ankle block duration and analgesia for foot and ankle surgery
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Secondary ID [1]
273339
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Nil
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Universal Trial Number (UTN)
U1111-1125-6893
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Trial acronym
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Foot and ankle analgesia
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Condition category
Condition code
Anaesthesiology
279302
279302
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0
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Pain management
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Patients undergoing elective ankle or foot surgery will receive an ultrasound guided ankle/foot block and be randomly allocated to one of three groups:
Arm 1
The intravenous dexamethasone group will receive 8 mg (2 ml) dexamethasone intravenously and 2 ml saline added to the ropivacaine ankle block.
Arm 2
The ankle block dexamethasone group will receive 8 mg (2 ml) dexamethasone added into the ropivacaine ankle block and 2 ml saline intravenously.
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Intervention code [1]
283682
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Treatment: Drugs
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Comparator / control treatment
Arm 3
Receive no dexamethasone. The control group will receive 2 ml saline intravenously and 2 ml saline added to the ropivacaine ankle block.
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Control group
Placebo
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Outcomes
Primary outcome [1]
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Duration before analgesic effect of block wears off as reported by the patient
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Assessment method [1]
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Timepoint [1]
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Checked at day 1 post-operatively as reported by the patient using a visual analogue scale
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Secondary outcome [1]
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Pain score at surgical site when the block had worn off
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Assessment method [1]
294753
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Timepoint [1]
294753
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Checked at day 1 post-operatively as reported by the patient using a visual analogue scale
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Secondary outcome [2]
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Highest pain score as reported by the patient within 7 days
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Assessment method [2]
294756
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Timepoint [2]
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Checked at day 7 post-operatively as reported by the patient using a visual analogue scale
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Secondary outcome [3]
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Nausea or vomiting
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Assessment method [3]
294757
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Timepoint [3]
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In post-operative recovery and on Day 7 as reported by the patient using patient self-report questionnaire
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Secondary outcome [4]
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Use of analgesic medication during first 7 days post-operatively
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Assessment method [4]
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Timepoint [4]
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Checked at day 7 post-operatively as reported by the patient using a patient self-report questionnaire
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Secondary outcome [5]
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Pain score immediately post-operatively
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Assessment method [5]
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Timepoint [5]
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Post anaesthetic care unit as reported by the patient using a visual analogue scale
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Secondary outcome [6]
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Adverse events related to having the ankle block including nerve damage. These adverse events will not be known beforehand and this is to screen for potential adverse reactions which are not expected to occur.
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Assessment method [6]
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Timepoint [6]
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Checked at day 1, day 7 and at the surgical postoperative consultation using patient self-report questionnaire
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Eligibility
Key inclusion criteria
Elective patients having metatarsal osteotomy for foot surgery
American Society of Anaesthesiologists score 1-3
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Minimum age
18
Years
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Maximum age
No limit
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
American Society of Anaesthesiologists score of 4 or greater
Contraindication to ankle block (patient refusal, coagulopathy, sepsis, local infection, allergy to ropivacaine)
Contraindication to dexamethasone (eg. known hypersensitivity, poorly controlled diabetes mellitus)
Pre-existing sensory deficit around the site of surgical intervention (eg. peripheral neuropathy, stroke)
Systemic glucocorticoid treatment of >10mg prednisolone (or equivalent) for two weeks or more within three months of surgery
Chronic opioid use define as >30mg oral morphine per day or equivalent (Fentanyl patch 12mcg/hr; buprenorphine 20mcg/hr; oxycodone >20mg/day)
Contraindication to non-steroidal anti-inflammatory drugs (NSAIDs) (eg. known hypersensitivity, active peptic ulcer disease, renal impairment, pregnancy)
Previous enrolment in this study
Inability to understand english
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Randomised controlled trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
Eligible patients will be provided with a patient information sheet at their preoperative visit. At the subsequent preoperative consultation, the surgeon will obtain verbal and written consent.
Subjects will be randomly allocated to a group using sealed opaque envelopes. A nurse who is not involved in the care of the enrolled subject will open the envelope and follow the instructions to draw up two syringes, one for the block and one for intravenous administration.
These syringes will be marked 'block' and 'intravenous' and given to the anaesthetist by another nurse.
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Permuted block randomisation using online computer software
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Masking / blinding
Blinded (masking used)
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Who is / are masked / blinded?
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Intervention assignment
Parallel
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Other design features
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Phase
Phase 4
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Type of endpoint/s
Efficacy
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Statistical methods / analysis
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Recruitment
Recruitment status
Recruiting
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Date of first participant enrolment
Anticipated
2/01/2012
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Actual
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Date of last participant enrolment
Anticipated
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Actual
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Date of last data collection
Anticipated
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Actual
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Sample size
Target
90
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Accrual to date
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Final
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Recruitment in Australia
Recruitment state(s)
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Recruitment postcode(s) [1]
4728
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5006
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Recruitment postcode(s) [2]
4729
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5065
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Funding & Sponsors
Funding source category [1]
284163
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Hospital
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Name [1]
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Burnside War Memorial Hospital
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Address [1]
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120 Kensington Road
Toorak Gardens
South Australia 5065
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Country [1]
284163
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Australia
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Funding source category [2]
284164
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Hospital
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Name [2]
284164
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The Memorial Hospital
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Address [2]
284164
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Sir Edwin Smith Avenue
North Adelaide
South Australia 5006
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Country [2]
284164
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Australia
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Primary sponsor type
Individual
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Name
Ms Rachel Dawson
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Address
Flinders Medical School
Flinders Drive
Bedford Park
South Australia 5042
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Country
Australia
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Secondary sponsor category [1]
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Individual
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Name [1]
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Dr David McLeod
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Address [1]
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Flinders Medical Centre
Flinders Drive
Bedford Park
South Australia 5042
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Country [1]
269119
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Australia
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Secondary sponsor category [2]
269120
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Individual
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Name [2]
269120
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Dr Jason Koerber
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Address [2]
269120
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Flinders Medical Centre
Flinders Drive
Bedford Park
South Australia 5042
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Country [2]
269120
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Australia
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Secondary sponsor category [3]
269121
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Individual
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Name [3]
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Dr George Dracopoulos
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Address [3]
269121
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Orthopaedics SA
First Floor
1 Kermode Street
North Adelaide
South Australia 5006
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Country [3]
269121
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Australia
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
286124
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South Adelaide Health Service Research Ethics Committee
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Ethics committee address [1]
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Research Ethics Office Flinders Medical Centre Flinders Drive Bedford Park South Australia 5042
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Ethics committee country [1]
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Australia
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Date submitted for ethics approval [1]
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11/11/2011
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Approval date [1]
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22/06/2012
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Ethics approval number [1]
286124
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Summary
Brief summary
Post operative pain following ankle and foot surgery is troublesome. It is common practice for regional anaesthetic blockade to be used to prolong post operative pain relief for about 14 hours. Dexamethasone has been shown to prolong regional blockade in the upper limb, but this has not been investigated in the lower limb. The optimal route of administration for dexamethasone has not been investigated and it is unknown whether there is advantage to administering dexamethasone intravenously, or mixed with the block. We aim to investigate whether dexamethasone can prolong regional anaesthesia in the lower limb and determine if there are differences in effect when administered intravenously compared with when it is added to the block.
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Trial website
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
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Address
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Country
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Phone
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Fax
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Email
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Contact person for public queries
Name
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Ms Rachel Dawson
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Address
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Flinders Medical School
Flinders Drive
Bedford Park
South Australia 5042
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Country
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Australia
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Phone
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+61403275926
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Fax
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Email
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[email protected]
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Contact person for scientific queries
Name
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Ms Rachel Dawson
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Address
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Flinders Medical School
Flinders Drive
Bedford Park
South Australia 5042
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Country
7532
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Australia
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Phone
7532
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+61403275926
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Fax
7532
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Email
7532
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[email protected]
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No information has been provided regarding IPD availability
What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
No additional documents have been identified.
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