Regional Anesthesia Block in Fibula Free Flap Reconstruction
Status:
Withdrawn
Trial end date:
2020-11-30
Target enrollment:
Participant gender:
Summary
Despite many recent advances in pain management, post-operative pain is widely considered to
be poorly managed. Furthermore, the mainstay of current pain management is opioids, for which
there is strong evidence of ill effects and long-term potential for addiction. There are many
studies demonstrating that perineural regional anesthesia can be superior to intravenous
opioid analgesia, and that the technique is safe. By using temporary implanted catheters,
this method can now deliver prolonged analgesia, thus reducing the need for opioids in the
postoperative period. Regional anesthesia is a proven technique and used daily by
anesthesiologists, and it is also the first choice for hip and knee replacement surgery for
orthopedic surgeons. Patients undergoing head and neck reconstruction with the use of free
tissue transfer experience a significant amount of post-operative pain due to the complexity
of the surgery, the presence of a head and neck surgical site as well as a secondary donor
site, and existing co-morbidities, most commonly malignancy, that also cause significant
pain. These patients often require opioids for pain control throughout the hospital stay, and
are almost always discharged home with additional opioids. By utilizing regional anesthesia
blocks at the donor sites, the investigators can potentially reduce post-operative pain while
also reducing the use of opioids.