Popliteal Plexus Block for Postoperative Pain After ACL Reconstruction
The Effect of the Popliteal Plexus Block on Postoperative Pain After Reconstruction of the Anterior Cruciate Ligament
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Detailed Description
Postoperative pain following ACL reconstruction can be alleviated with an ultrasound-guided femoral triangle block (FTB). However, it is the investigators' observation that 10-20 % of the patients still complain of intense pain localized in the center of the knee.
Cadaver dissection studies have shown that an injection into the distal part of the adductor canal will spread to the popliteal fossa, and one dissection study showed consistent spread to the popliteal plexus.
The study team hypothesized that a PPB will reduce the postoperative pain, when it is used as a supplement to the FTB in patients undergoing ACL reconstruction.
Study Type
Study Type
Enrollment (Actual)
Enrollment
Phase
Phase
- Not Applicable
Contacts and Locations
Study Locations
-
-
-
Aarhus C, Denmark, 8000
- Aarhus University Hospital
-
Horsens, Denmark, 8700
- The Regional Hospital in Horsens
-
-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Patients undergoing ACL reconstruction on one of the two trial sites
- Age ≥ 18
- American Society of Anesthesiologists (ASA) status I-III
- Informed consent
Exclusion Criteria:
- Patients unable to cooperate
- Patients not able to speak Danish or with other communication problems
- Pregnancy
- Contraindication towards any medical product used in the study
- Preoperatively reduced sensation on the medial and lateral part of the lower leg
- Patients with diabetes requiring medical treatment
- Preoperative intake of opioids (dosed > once daily)
- ACL revision
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Non-Randomized
- Interventional Model: Parallel Assignment
- Masking: None (Open Label)
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Experimental: Patients with postoperative pain, NRS >3
Patients reporting postoperative pain (NRS >3) localized to the center of the knee (10 patients) will receive a popliteal plexus block
|
10 mL Marcain-adrenalin 5 mg/mL + 5 microgram/mL.
Ultrasound-guided injection into the distal part of the adductor canal
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|
No Intervention: Patients with postoperative pain, NRS ≤ 3
(approx. 90 patients)
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
The effect of the popliteal plexus block (PPB)
Time Frame: Pain scores (NRS): 15, 30, 45 and 60 minutes after PPB
|
Evaluated as the percentage of patients with postoperative pain NRS >3, dropping in pain score to NRS ≤ 3 after the PPB
|
Pain scores (NRS): 15, 30, 45 and 60 minutes after PPB
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Percentage of patients with central knee pain
Time Frame: Pain scores: 15, 30, 45 and 60 minutes after arrival at the post anesthesia care unit (PACU)
|
The percentage of patients with FTB reporting pain (NRS >3) localized in the center of the knee in the observation period
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Pain scores: 15, 30, 45 and 60 minutes after arrival at the post anesthesia care unit (PACU)
|
|
Onset time for PPB
Time Frame: Pain scores (NRS): 15, 30, 45 and 60 minutes after PPB
|
Time from withdrawal of the needle until patient reports NRS ≤ 3
|
Pain scores (NRS): 15, 30, 45 and 60 minutes after PPB
|
|
The effect of the PPB on cutaneous sensation
Time Frame: Baseline, 30 and 60 minutes after PPB
|
Tested on the lateral part of the lower leg (pinprick test)
|
Baseline, 30 and 60 minutes after PPB
|
|
The effect of the PPB on muscle strength
Time Frame: Baseline, 60 minutes after PPB
|
Dorsal flexion and plantar flexion in the ankle joint, measured with a handheld dynamometer)
|
Baseline, 60 minutes after PPB
|
Collaborators and Investigators
Sponsor
Sponsor
Investigators
Investigators
- Principal Investigator: Jan M Jensen, MD, Aarhus University Hospital
- Principal Investigator: Christian Jessen, MD, The Regional Hospital in Horsens
Publications and helpful links
General Publications
- Grevstad U, Mathiesen O, Valentiner LS, Jaeger P, Hilsted KL, Dahl JB. Effect of adductor canal block versus femoral nerve block on quadriceps strength, mobilization, and pain after total knee arthroplasty: a randomized, blinded study. Reg Anesth Pain Med. 2015 Jan-Feb;40(1):3-10. doi: 10.1097/AAP.0000000000000169.
- Bendtsen TF, Moriggl B, Chan V, Borglum J. The Optimal Analgesic Block for Total Knee Arthroplasty. Reg Anesth Pain Med. 2016 Nov/Dec;41(6):711-719. doi: 10.1097/AAP.0000000000000485.
- Wong WY, Bjorn S, Strid JM, Borglum J, Bendtsen TF. Defining the Location of the Adductor Canal Using Ultrasound. Reg Anesth Pain Med. 2017 Mar/Apr;42(2):241-245. doi: 10.1097/AAP.0000000000000539.
- Goffin P, Lecoq JP, Ninane V, Brichant JF, Sala-Blanch X, Gautier PE, Bonnet P, Carlier A, Hadzic A. Interfascial Spread of Injectate After Adductor Canal Injection in Fresh Human Cadavers. Anesth Analg. 2016 Aug;123(2):501-3. doi: 10.1213/ANE.0000000000001441.
Study record dates
Study Major Dates
Study Start (Actual)
Study Start
Primary Completion (Actual)
Primary Completion
Study Completion (Actual)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Actual)
First Posted
Study Record Updates
Last Update Posted (Actual)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
Other Study ID Numbers
Other Study ID Numbers
- Protokol_PPB_ACL_21042017
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
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