Postoperative Analgesia Using a Perineural Catheter Versus a Single Nerve Block in Rearfoot Surgery

NCT07638514 — Recruiting, 60 participants, University Hospital, Angers

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A Comparative Evaluation of Postoperative Analgesia Using a Perineural Catheter Versus a Single Nerve Block in Rearfoot Surgery

Registry	NCT07638514, acronym CATHORNOT
Status	Recruiting
Study type	Observational
Enrollment	60 (Estimated)
Sponsor	University Hospital, Angers (Other gov)
Conditions	Hindfoot Surgery, Analgesia, Perineural Catheter
Interventions	Phone contact, perineural catheter, Regional Anesthesia (Other, device, procedure)
Dates	start 2026-09-14, primary completion 2027-02-14 (estimated), completion 2027-03-14 (estimated), first posted 2026-06-10, last updated 2026-09-22
Locations	1 site in France

-Summary

Postoperative pain following hindfoot surgery is often severe and can persist for several days. It frequently leads to the use of systemic analgesics, particularly opioids, whose adverse effects are well known. Furthermore, poorly controlled postoperative pain is a recognized independent risk factor for the development of chronic pain.

Ambulatory perineural catheter techniques, already used in our department for hindfoot surgeries, allow for continuous infusion of local anesthetic. They have demonstrated their efficacy in numerous orthopedic surgeries, but data specific to hindfoot surgery remain limited. It therefore seems appropriate to evaluate whether prolonged analgesia via a perineural catheter improves postoperative pain management and promotes functional recovery.

The study is conducted as a practice evaluation audit. It relies on the collection of data from routine care, without any modification to intraoperative care. This methodology allows for an objective evaluation of the benefits of the perineural catheter compared to a single-injection popliteal sciatic block with local anesthetic, while documenting the frequency and nature of complications associated with the technique (leaks, accidental or intentional catheter removal).

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+Arms and interventions

Arm	Type	Interventions	Description
regional anesthesia		Other: Phone contact; Procedure: Regional Anesthesia
ambulatory perineural catheter		Other: Phone contact; Device: perineural catheter

Phone contact (Other): All patients are contacted by phone to assess pain during movement and at rest on each of the first 3 days after surgery, as well as their use of various pain medications
perineural catheter (Device): Use of a perineural catheter for ambulatory analgesia
Regional Anesthesia (Procedure): regional anesthesia

+Outcome measures

Primary outcomes

Pain on movement using a numerical scale from 0 (no pain) to 10 (maximum pain) [Day 1 postoperative]: Postoperative pain on movement at Day 1. Pain intensity during movement assessed using an 11-point Numerical Rating Scale (NRS; 0 = no pain, 10 = worst possible pain)

Secondary outcomes

postoperative pain at rest using a numerical scale from 0 (no pain) to 10 (maximum pain) [Postoperative Day 0 through Postoperative Day 3]: to assess analgesic efficacy at rest
postoperative pain during mobilization using a numerical scale from 0 (no pain) to 10 (maximum pain) [From Baseline to Day 3]: to evaluate the analgesic efficacy during mobilization
Postoperative consumption of morphine equivalents in milligrams [Postoperative Day 0 through Postoperative Day 3]: Cumulative
Daily postoperative consumption of morphine equivalents in milligrams [Baseline, Day 1, Day 2 and Day 3]: Daily
Postoperative use of non-opioid analgesics [Postoperative Day 0 through Postoperative Day 3]: Cumulative
Daily postoperative use of non-opioid analgesics [Baseline, Day 1, Day 2 and Day 3]: Daily
French Quality of Recovery -15 score (FQoR-15 - from 0 to 150) [Postoperative Day 0 through Postoperative Day 2]: to assess functional recovery and postoperative rehabilitation
Proportion of patients experiencing at least one adverse event related to the regional anesthesia technique [Postoperative Day 0 through Postoperative Day 3]: Accidental or intentional removal of the catheter Leaks at the injection site or in the infusion system Bruise or local infection Falls potentially related to the residual motor block
proportion of patients experiencing at least one postoperative complication following hindfoot surgery [Postoperative Day 0 through Postoperative Day 3]: Readmission to the hospital Consultation with the attending physician for uncontrolled postoperative pain or complications related to the procedure Confirmed infection with antibiotic treatment initiated
length of hospital stay, calculated in whole days [Postoperative Day 0 through Postoperative Day 3]: Duration censored on Day 3 if the patient is still hospitalized on that date

+Eligibility

Sex: All, ages: 18 Years to any

Inclusion Criteria:

* Adult patients;
* Patients with an American Society of Anesthesiologists physical status (ASA score) of 1, 2, or 3;
* Patients who have undergone hindfoot surgery;
* Patients capable of completing the questionnaires.

Exclusion Criteria:

* Contraindications to regional anesthesia (known hypersensitivity to the local anesthetic, infection at the injection site, uncontrolled neurological condition);
* Emergency surgery
* Cognitive impairment;
* Uncontrolled psychiatric condition;
* Pregnancy or breastfeeding;
* Substance abuse;
* Use of neuroleptics or lithium;
* Individuals subject to legal guardianship
* Individuals deprived of liberty by judicial or administrative order
* Patients who object to the study.

+Locations (1)

Facility	City	Country	Status
University Hospital of Angers	Angers	France	Recruiting

+Investigators

Benjamin DUMARTINET, Principal investigator, University Hospital of Angers