Trial Outcomes & Findings for MIDCAB (Mid-Calf Block) for Foot Surgery (NCT NCT05368012)

NCT ID: NCT05368012

Last Updated: 2025-04-15

Results Overview

The primary outcome will be block duration, how long the MIDCAB block provides analgesia. This will be measured via questionnaires of pain scores given to patients post surgical discharge (in PACU), 24h post surgical discharge, 48 hours post surgical discharge, and 1 week post surgical discharge. This will be done by measuring the change in patient's pains scores over the course of 7 days. Pain scores will be measured via NRS pain scale; the NRS (numeric rating scale) is a questionnaire that measures pain on a numeric scale, 0 (no pain) to 10 (worst pain imaginable). Patients will be asked to state the specific time-points they began to have pain after surgery.

Recruitment status

COMPLETED

Study phase

PHASE4

Target enrollment

20 participants

Primary outcome timeframe

Out to 1 week postoperatively

Results posted on

2025-04-15

Participant Flow

Participant milestones

Participant milestones
Measure
Treatment
A total of 20 patients will be enrolled and will receive the stand of care analgesic protocol in addition to the following MIDCAB nerve block. There is only one treatment group in this study, no placebo group. The rationale behind there being one group is that this is a small pilot study that intends to inform subsequent randomized clinical control trials.
Overall Study
STARTED
20
Overall Study
COMPLETED
20
Overall Study
NOT COMPLETED
0

Reasons for withdrawal

Withdrawal data not reported

Baseline Characteristics

MIDCAB (Mid-Calf Block) for Foot Surgery

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
Active MIDCAB
n=20 Participants
USG with a 25G needle, Bupivacaine 0.5% 30ml with 4mg preservative free dexamethasone divided as follows into the following 5 nerves: Posterior Tibial nerve (10ml), Saphenous nerve (5ml), Deep peroneal Nerve (5ml), Superficial peroneal nerve (5 ml), and Sural Nerve (5ml). MIDCAB: Ultrasound-guided administration of the nerve block MIDCAB into mid-calf as analgesic intervention for patients.
Age, Continuous
56.1 years
STANDARD_DEVIATION 13.3 • n=5 Participants
Sex: Female, Male
Female
12 Participants
n=5 Participants
Sex: Female, Male
Male
8 Participants
n=5 Participants
Ethnicity (NIH/OMB)
Hispanic or Latino
0 Participants
n=5 Participants
Ethnicity (NIH/OMB)
Not Hispanic or Latino
20 Participants
n=5 Participants
Ethnicity (NIH/OMB)
Unknown or Not Reported
0 Participants
n=5 Participants
Race (NIH/OMB)
American Indian or Alaska Native
0 Participants
n=5 Participants
Race (NIH/OMB)
Asian
0 Participants
n=5 Participants
Race (NIH/OMB)
Native Hawaiian or Other Pacific Islander
0 Participants
n=5 Participants
Race (NIH/OMB)
Black or African American
1 Participants
n=5 Participants
Race (NIH/OMB)
White
19 Participants
n=5 Participants
Race (NIH/OMB)
More than one race
0 Participants
n=5 Participants
Race (NIH/OMB)
Unknown or Not Reported
0 Participants
n=5 Participants
Region of Enrollment
United States
20 participants
n=5 Participants

PRIMARY outcome

Timeframe: Out to 1 week postoperatively

The primary outcome will be block duration, how long the MIDCAB block provides analgesia. This will be measured via questionnaires of pain scores given to patients post surgical discharge (in PACU), 24h post surgical discharge, 48 hours post surgical discharge, and 1 week post surgical discharge. This will be done by measuring the change in patient's pains scores over the course of 7 days. Pain scores will be measured via NRS pain scale; the NRS (numeric rating scale) is a questionnaire that measures pain on a numeric scale, 0 (no pain) to 10 (worst pain imaginable). Patients will be asked to state the specific time-points they began to have pain after surgery.

Outcome measures

Outcome measures
Measure
Active MIDCAB
n=20 Participants
USG with a 25G needle, Bupivacaine 0.5% 30ml with 4mg preservative free dexamethasone divided as follows into the following 5 nerves: Posterior Tibial nerve (10ml), Saphenous nerve (5ml), Deep peroneal Nerve (5ml), Superficial peroneal nerve (5 ml), and Sural Nerve (5ml). MIDCAB: Ultrasound-guided administration of the nerve block MIDCAB into mid-calf as analgesic intervention for patients.
Block Duration
18.2 hours
Interval 4.5 to 24.0

SECONDARY outcome

Timeframe: Measured in the PACU (post-anesthesia care unit) immediately upon patients arrival into the PACU, up to 1 hour after surgery.

The return of the patient's foot/ankle motor function which will be measured by whether the patient can dorsiflex/plantarflex at the ankle or have flexion/extension of the toes.

Outcome measures

Outcome measures
Measure
Active MIDCAB
n=20 Participants
USG with a 25G needle, Bupivacaine 0.5% 30ml with 4mg preservative free dexamethasone divided as follows into the following 5 nerves: Posterior Tibial nerve (10ml), Saphenous nerve (5ml), Deep peroneal Nerve (5ml), Superficial peroneal nerve (5 ml), and Sural Nerve (5ml). MIDCAB: Ultrasound-guided administration of the nerve block MIDCAB into mid-calf as analgesic intervention for patients.
Number of Participants With Return of Motor Function of Foot and Ankle Post-Operatively
20 Participants

SECONDARY outcome

Timeframe: PACU (up until patients' discharge from the hospital), POD1 (Around 24 hrs after the PACU arrival time), POD2 (Around 48 hrs after the PACU arrival time) & POD7 (Around 1 week from the PACU arrival time)

Cumulative opioid consumption in morphine equivalents will be recorded post surgical discharge (in PACU), 24h post surgical discharge, 48 hours post surgical discharge, and 1 week post surgical discharge.

Outcome measures

Outcome measures
Measure
Active MIDCAB
n=20 Participants
USG with a 25G needle, Bupivacaine 0.5% 30ml with 4mg preservative free dexamethasone divided as follows into the following 5 nerves: Posterior Tibial nerve (10ml), Saphenous nerve (5ml), Deep peroneal Nerve (5ml), Superficial peroneal nerve (5 ml), and Sural Nerve (5ml). MIDCAB: Ultrasound-guided administration of the nerve block MIDCAB into mid-calf as analgesic intervention for patients.
Cumulative Opioid Consumption
PACU
0 mg oral morphine equivalents
Interval 0.0 to 7.5
Cumulative Opioid Consumption
POD1
15 mg oral morphine equivalents
Interval 0.0 to 33.8
Cumulative Opioid Consumption
POD2
8.8 mg oral morphine equivalents
Interval 3.8 to 27.0
Cumulative Opioid Consumption
POD7
30 mg oral morphine equivalents
Interval 7.5 to 67.5

SECONDARY outcome

Timeframe: POD 7 (1 week post-surgical discharge)

Patients will be asked if they have any residual numbness in the foot or toes where the surgery took place.

Outcome measures

Outcome measures
Measure
Active MIDCAB
n=20 Participants
USG with a 25G needle, Bupivacaine 0.5% 30ml with 4mg preservative free dexamethasone divided as follows into the following 5 nerves: Posterior Tibial nerve (10ml), Saphenous nerve (5ml), Deep peroneal Nerve (5ml), Superficial peroneal nerve (5 ml), and Sural Nerve (5ml). MIDCAB: Ultrasound-guided administration of the nerve block MIDCAB into mid-calf as analgesic intervention for patients.
Presence of Paresthesia (Numbness)
5 Participants

SECONDARY outcome

Timeframe: POD 7 (1 week post-surgical discharge)

Patients will be asked if they have any wounds or irritation to the skin (i.e. rashes, itching, burning, etc.) on the skin at the site of surgery and/or site of the block.

Outcome measures

Outcome measures
Measure
Active MIDCAB
n=20 Participants
USG with a 25G needle, Bupivacaine 0.5% 30ml with 4mg preservative free dexamethasone divided as follows into the following 5 nerves: Posterior Tibial nerve (10ml), Saphenous nerve (5ml), Deep peroneal Nerve (5ml), Superficial peroneal nerve (5 ml), and Sural Nerve (5ml). MIDCAB: Ultrasound-guided administration of the nerve block MIDCAB into mid-calf as analgesic intervention for patients.
Presence of Skin Irritation and Wounds
2 Participants

SECONDARY outcome

Timeframe: PACU (up until patients' discharge from the hospital), POD1 (Around 24 hrs after the PACU arrival time), POD2 (Around 48 hrs after the PACU arrival time) & POD7 (Around 1 week from the PACU arrival time)

The questionnaire used asks patients if they have experienced any nausea.

Outcome measures

Outcome measures
Measure
Active MIDCAB
n=20 Participants
USG with a 25G needle, Bupivacaine 0.5% 30ml with 4mg preservative free dexamethasone divided as follows into the following 5 nerves: Posterior Tibial nerve (10ml), Saphenous nerve (5ml), Deep peroneal Nerve (5ml), Superficial peroneal nerve (5 ml), and Sural Nerve (5ml). MIDCAB: Ultrasound-guided administration of the nerve block MIDCAB into mid-calf as analgesic intervention for patients.
Presence of Nausea
POD1
2 Participants
Presence of Nausea
POD2
3 Participants
Presence of Nausea
POD7
2 Participants
Presence of Nausea
PACU
1 Participants

SECONDARY outcome

Timeframe: PACU (up until patients' discharge from the hospital), POD1 (Around 24 hrs after the PACU arrival time), POD2 (Around 48 hrs after the PACU arrival time) & POD7 (Around 1 week from the PACU arrival time)

Population: The number analyzed is different than the overall number analyzed due to the fact that not every patient experienced any nausea. Only the patients who experienced nausea then got the follow up question about the severity of it.

Patients are asked on a scale from 0-10 (0 being not severe and 10 being the worst severity) how severe their nausea was. This will be measured post surgical discharge (in PACU), 24h post surgical discharge, 48 hours post surgical discharge, and 1 week post surgical discharge

Outcome measures

Outcome measures
Measure
Active MIDCAB
n=20 Participants
USG with a 25G needle, Bupivacaine 0.5% 30ml with 4mg preservative free dexamethasone divided as follows into the following 5 nerves: Posterior Tibial nerve (10ml), Saphenous nerve (5ml), Deep peroneal Nerve (5ml), Superficial peroneal nerve (5 ml), and Sural Nerve (5ml). MIDCAB: Ultrasound-guided administration of the nerve block MIDCAB into mid-calf as analgesic intervention for patients.
Severity of Nausea
PACU
3 Scores on a scale
Interval 3.0 to 3.0
Severity of Nausea
POD1
6.5 Scores on a scale
Interval 6.0 to 7.0
Severity of Nausea
POD2
3.67 Scores on a scale
Interval 2.0 to 5.0
Severity of Nausea
POD7
3 Scores on a scale
Interval 3.0 to 3.0

SECONDARY outcome

Timeframe: PACU (up until patients' discharge from the hospital), POD1 (Around 24 hrs after the PACU arrival time), POD2 (Around 48 hrs after the PACU arrival time) & POD7 (Around 1 week from the PACU arrival time)

Population: The number analyzed is different than the overall number analyzed due to the fact that not every patient experienced any nausea. Only the patients who experienced nausea then got the follow up question about the severity of it.

Patients were asked how many episodes of nausea had occurred.

Outcome measures

Outcome measures
Measure
Active MIDCAB
n=20 Participants
USG with a 25G needle, Bupivacaine 0.5% 30ml with 4mg preservative free dexamethasone divided as follows into the following 5 nerves: Posterior Tibial nerve (10ml), Saphenous nerve (5ml), Deep peroneal Nerve (5ml), Superficial peroneal nerve (5 ml), and Sural Nerve (5ml). MIDCAB: Ultrasound-guided administration of the nerve block MIDCAB into mid-calf as analgesic intervention for patients.
Number of Total Episodes of Nausea
PACU
1 episodes
Interval 1.0 to 1.0
Number of Total Episodes of Nausea
POD1
2 episodes
Interval 1.0 to 3.0
Number of Total Episodes of Nausea
POD2
1.33 episodes
Interval 1.0 to 2.0
Number of Total Episodes of Nausea
POD7
1.5 episodes
Interval 1.0 to 2.0

Adverse Events

Active MIDCAB

Serious events: 0 serious events
Other events: 0 other events
Deaths: 0 deaths

Serious adverse events

Adverse event data not reported

Other adverse events

Adverse event data not reported

Additional Information

MIDCAB (Mid-Calf Block) for foot surgery: A pilot study

Hospital for Special Surgery

Phone: 646-797-8948

Results disclosure agreements

  • Principal investigator is a sponsor employee
  • Publication restrictions are in place