{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,16]],"date-time":"2026-07-16T23:44:22Z","timestamp":1784245462815,"version":"3.55.0"},"reference-count":34,"publisher":"BMJ","issue":"5","funder":[{"name":"Viggo og Krista Pedersens Fond"},{"name":"Forskningsrdet, Herlev Hospital"},{"name":"Dansk Selskab for Anstesi og Intensiv Medicin"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2017,4,12]]},"published-print":{"date-parts":[[2017,5]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Ankle fracture surgery is a common procedure, but the influence of anaesthesia choice on postoperative pain and quality of recovery is poorly understood. Some authors suggest a benefit of peripheral nerve block (PNB) in elective procedures, but the different pain profile following acute fracture surgery and the rebound pain on cessation of the PNB both remain unexplored. We present an ongoing randomised study aiming to compare primary PNB anaesthesia with spinal anaesthesia for ankle fracture surgery regarding postoperative pain profiles and quality of recovery.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and analysis<\/jats:title>\n                    <jats:p>AnAnkle Trial is a randomised, dual-centre, open-label, blinded analysis trial of 150 adult patients undergoing primary internal fixation of an ankle fracture. Main exclusion criteria are habitual opioid use, impaired pain sensation, other painful injuries or cognitive impairment. The intervention is ultrasound-guided popliteal sciatic (20\u2009mL) and saphenal nerve (8\u2009mL) PNB with ropivacaine 7.5\u2009mg\/mL, and controls receive spinal anaesthesia (2\u2009mL) with hyperbaric bupivacaine 5\u2009mg\/mL. Postoperatively all receive paracetamol, ibuprofen and patient-controlled intravenous morphine on demand. Morphine consumption and pain scores are registered in the first 27\u2009hours and reported as an integrated pain score as the primary endpoint. Pain score intervals are 3\u2009hours and we will use the area under curve to get a longitudinal measure of pain. Secondary outcomes include rebound pain on cessation of anaesthesia, opioid side effects (Opioid-Related Symptom Distress Scale), quality of recovery (Danish Quality of Recovery-15 score) and pain scores and medication days 1\u20137 (diary).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Ethics and dissemination<\/jats:title>\n                    <jats:p>The study has been approved by the Regional Ethics Committees in the Capital Region of Denmark, the Danish Data Protection Agency and the Danish Health and Medical Authority. We will publish the results in international peer-reviewed medical journals.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial registration number<\/jats:title>\n                    <jats:p>AnAnkle Trial is registered in the European Clinical Trials Database (EudraCT 2015-001108-76).<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2017-016001","type":"journal-article","created":{"date-parts":[[2017,6,2]],"date-time":"2017-06-02T20:10:12Z","timestamp":1496434212000},"page":"e016001","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":16,"title":["AnAnkle Trial study protocol: a randomised trial comparing pain profiles after peripheral nerve block or spinal anaesthesia for ankle fracture surgery"],"prefix":"10.1136","volume":"7","author":[{"given":"Rune","family":"Sort","sequence":"first","affiliation":[{"name":"Department of Anaesthesiology, Herlev and Gentofte University Hospital, Copenhagen, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stig","family":"Brorson","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Herlev and Gentofte University Hospital, Copenhagen, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ismail","family":"G\u00f6genur","sequence":"additional","affiliation":[{"name":"Department of Surgery, Centre for Surgical Science, Zealand University Hospital, Copenhagen, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ann Merete","family":"M\u00f8ller","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology, Herlev and Gentofte University Hospital, Copenhagen, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2017,6,2]]},"reference":[{"key":"2025121400243446000_7.5.e016001.1","doi-asserted-by":"publisher","DOI":"10.3109\/17453678709146395"},{"key":"2025121400243446000_7.5.e016001.2","doi-asserted-by":"publisher","DOI":"10.3109\/17453679809002355"},{"key":"2025121400243446000_7.5.e016001.3","doi-asserted-by":"crossref","first-page":"24","DOI":"10.1177\/0310057X0703500103","article-title":"Long-term neurological complications associated with surgery and peripheral nerve blockade: outcomes after 1065 consecutive blocks","volume":"35","author":"Watts","year":"2007","journal-title":"Anaesth Intensive Care"},{"key":"2025121400243446000_7.5.e016001.4","doi-asserted-by":"crossref","first-page":"65","DOI":"10.1213\/00000539-200201000-00012","article-title":"Ambulatory discharge after long-acting peripheral nerve blockade: 2382 blocks with ropivacaine","volume":"94","author":"Klein","year":"2002","journal-title":"Anesth Analg"},{"key":"2025121400243446000_7.5.e016001.5","doi-asserted-by":"publisher","DOI":"10.1093\/bja\/aeq273"},{"key":"2025121400243446000_7.5.e016001.6","doi-asserted-by":"publisher","DOI":"10.1097\/00000542-200511000-00018"},{"key":"2025121400243446000_7.5.e016001.7","doi-asserted-by":"publisher","DOI":"10.1097\/AAP.0b013e31825cb3d6"},{"key":"2025121400243446000_7.5.e016001.8","doi-asserted-by":"publisher","DOI":"10.1097\/00000542-199907000-00006"},{"key":"2025121400243446000_7.5.e016001.9","doi-asserted-by":"crossref","first-page":"1043","DOI":"10.3113\/FAI.2010.1043","article-title":"Continuous infusion versus single bolus popliteal block following Major ankle and hindfoot surgery: a prospective, randomized trial","volume":"31","author":"Elliot","year":"2010","journal-title":"Foot Ankle Int"},{"key":"2025121400243446000_7.5.e016001.10","doi-asserted-by":"crossref","first-page":"1303","DOI":"10.1213\/01.ANE.0000082242.84015.D4","article-title":"The use of a continuous popliteal sciatic nerve block after surgery involving the foot and ankle: does it improve the quality of recovery?","volume":"97","author":"White","year":"2003","journal-title":"Anesth Analg"},{"key":"2025121400243446000_7.5.e016001.11","doi-asserted-by":"crossref","first-page":"1634","DOI":"10.1213\/01.ANE.0000180829.70036.4F","article-title":"A comparison of regional versus general anesthesia for ambulatory anesthesia: a meta-analysis of randomized controlled trials","volume":"101","author":"Liu","year":"2005","journal-title":"Anesth Analg"},{"key":"2025121400243446000_7.5.e016001.12","doi-asserted-by":"crossref","first-page":"1271","DOI":"10.3113\/FAI.2007.1271","article-title":"Preoperative lateral popliteal nerve block for intraoperative and postoperative pain control in elective foot and ankle surgery: a prospective analysis","volume":"28","author":"Grosser","year":"2007","journal-title":"Foot Ankle Int"},{"key":"2025121400243446000_7.5.e016001.13","doi-asserted-by":"crossref","unstructured":"Xu J , Chen X , Ma C , et al . Peripheral nerve blocks for postoperative pain after major knee surgery. Wang X , ed. Cochrane Database of Systematic Reviews, 2014. CD010937.","DOI":"10.1002\/14651858.CD010937"},{"key":"2025121400243446000_7.5.e016001.14","doi-asserted-by":"crossref","unstructured":"Chan E-Y , Fransen M , Parker DA , et al . Femoral nerve blocks for acute postoperative pain after knee replacement surgery. Chan E-Y , ed. Cochrane Database of Systematic Reviews. Chichester, UK:: John Wiley & Sons, Ltd, 2014. CD009941.","DOI":"10.1002\/14651858.CD009941.pub2"},{"key":"2025121400243446000_7.5.e016001.15","first-page":"109","article-title":"Randomized comparison of remifentanil-propofol with a sciatic-femoral nerve block for out-patient knee arthroscopy","volume":"19","author":"Casati","year":"2002","journal-title":"Eur J Anaesthesiol"},{"key":"2025121400243446000_7.5.e016001.16","doi-asserted-by":"crossref","first-page":"1003","DOI":"10.1213\/01.ANE.0000081798.89853.E7","article-title":"A comparison of psoas compartment block and spinal and general anesthesia for outpatient knee arthroscopy","volume":"97","author":"Jankowski","year":"2003","journal-title":"Anesth Analg"},{"key":"2025121400243446000_7.5.e016001.17","doi-asserted-by":"publisher","DOI":"10.1097\/BOT.0b013e3182638b25"},{"key":"2025121400243446000_7.5.e016001.18","doi-asserted-by":"crossref","first-page":"584","DOI":"10.1007\/s00508-010-1451-9","article-title":"Benefit of the minimal invasive ultrasound-guided single shot femoro-popliteal block for ankle surgery in comparison with spinal anesthesia","volume":"122","author":"Proti\u0107","year":"2010","journal-title":"Wien Klin Wochenschr"},{"key":"2025121400243446000_7.5.e016001.19","doi-asserted-by":"crossref","first-page":"870","DOI":"10.1097\/AJP.0000000000000335","article-title":"The effects of Anesthetic Technique on Postoperative opioid consumption in ankle fracture surgery","volume":"32","author":"Christensen","year":"2016","journal-title":"Clin J Pain"},{"key":"2025121400243446000_7.5.e016001.20","doi-asserted-by":"publisher","DOI":"10.1097\/EJA.0000000000000118"},{"key":"2025121400243446000_7.5.e016001.21","unstructured":"The European Medicines Agency. EudraCT public website: BMJ Publishing Group. https:\/\/eudract.ema.europa.eu\/."},{"key":"2025121400243446000_7.5.e016001.22","unstructured":"The European Medicines Agency. EU clinical trials Register. https:\/\/www.clinicaltrialsregister.eu\/."},{"key":"2025121400243446000_7.5.e016001.23","doi-asserted-by":"crossref","first-page":"767","DOI":"10.1016\/j.jpain.2013.04.004","article-title":"Integration of pain score and morphine consumption in analgesic clinical studies","volume":"14","author":"Dai","year":"2013","journal-title":"J Pain"},{"key":"2025121400243446000_7.5.e016001.24","doi-asserted-by":"publisher","DOI":"10.2307\/2289477"},{"key":"2025121400243446000_7.5.e016001.25","doi-asserted-by":"publisher","DOI":"10.1007\/s11136-009-9547-2"},{"key":"2025121400243446000_7.5.e016001.26","doi-asserted-by":"publisher","DOI":"10.1213\/ANE.0b013e31821ae3f7"},{"key":"2025121400243446000_7.5.e016001.27","doi-asserted-by":"crossref","first-page":"912","DOI":"10.1111\/aas.12525","article-title":"Translation and validation of the Danish version of the postoperative quality of recovery score QoR-15","volume":"59","author":"Kleif","year":"2015","journal-title":"Acta Anaesthesiol Scand"},{"key":"2025121400243446000_7.5.e016001.28","doi-asserted-by":"publisher","DOI":"10.1213\/01.ANE.0000133143.60584.38"},{"key":"2025121400243446000_7.5.e016001.29","first-page":"0","article-title":"Common Terminology Criteria for adverse events (CTCAE)","volume":"2009","author":"National Institute of Cancer","year":"2010","journal-title":"NIH Publ"},{"key":"2025121400243446000_7.5.e016001.30","doi-asserted-by":"publisher","DOI":"10.1097\/ALN.0b013e3181aae87a"},{"key":"2025121400243446000_7.5.e016001.31","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.c869"},{"key":"2025121400243446000_7.5.e016001.32","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.e7586"},{"key":"2025121400243446000_7.5.e016001.33","doi-asserted-by":"publisher","DOI":"10.2106\/JBJS.H.01852"},{"key":"2025121400243446000_7.5.e016001.34","doi-asserted-by":"publisher","DOI":"10.1016\/j.pain.2008.06.025"}],"container-title":["BMJ Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmjopen-2017-016001","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,14]],"date-time":"2025-12-14T08:24:44Z","timestamp":1765700684000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmjopen.bmj.com\/lookup\/doi\/10.1136\/bmjopen-2017-016001"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017,5]]},"references-count":34,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2017,6,2]]},"published-print":{"date-parts":[[2017,5]]}},"alternative-id":["10.1136\/bmjopen-2017-016001"],"URL":"https:\/\/doi.org\/10.1136\/bmjopen-2017-016001","relation":{},"ISSN":["2044-6055","2044-6055"],"issn-type":[{"value":"2044-6055","type":"print"},{"value":"2044-6055","type":"electronic"}],"subject":[],"published":{"date-parts":[[2017,5]]}}}