Continuous Adductor Canal Block for Total Knee Arthroplasty Analgesia

Prospective Comparison Between Continuous Femoral Nerve Block and the Association of Adductor Canal Block and Sciatic Nerve Block in Total Knee Arthroplasty.

The purpose of the study is to determine whether the association of sciatic nerve block to continuous adductor canal block is effective in the treatment of total knee arthroplasty post operative pain .

Study Overview

• Status: Unknown
• Conditions: Pain Management; Neuromuscular Blockade
• Intervention / Treatment: Drug: Saline; Procedure: Continuous femoral nerve block; Procedure: Continuous adductor canal block; Procedure: infragluteal Sciatic nerve block; Drug: Ropivacaine 0.2%

• Study Type: Interventional
• Enrollment (Anticipated): 80
• Phase: Not Applicable

Contacts and Locations

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years to 90 years (Adult, Older Adult)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

Description

Inclusion Criteria:

• Elective unilateral TKA,
• Planned continuous spinal anesthesia ,
• Ability to follow study protocol,
• American Society of Anesthesiologists class 1 to 3.

Exclusion Criteria:

• Contraindication for neuraxial anesthetic,
• Chronic opioid use (defined as daily or almost daily use of opioids for >3 months),
• Hypersensitivity and/or allergies to any of the study medications,
• Intraoperative use of volatile anesthetics,
• Preexisting neuropathy on the operative limb,
• Contraindications to a femoral, adductor canal or Tibial nerve block.

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: Quadruple

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Active Comparator: Continous femoral nerve block; Patients will receive ultrasound-guided (USG) continuous femoral nerve block with 20 ml ropivacaine 0.2% and USG Continuous adductor canal block with 20 ml of saline and USG infragluteal SNB with 20 ml of saline .	Drug: Saline; Procedure: Continuous femoral nerve block; Procedure: Continuous adductor canal block; Procedure: infragluteal Sciatic nerve block; Drug: Ropivacaine 0.2%
Experimental: Continuous adductor canal block; Patients will receive ultrasound-guided continuous adductor canal block with 20 ml ropivacaine 0.2% and USG infragluteal SNB with 20 ml ropivacaine 0.2% and USG continuous FNB with 20 ml of saline .	Drug: Saline; Procedure: Continuous femoral nerve block; Procedure: Continuous adductor canal block; Procedure: infragluteal Sciatic nerve block; Drug: Ropivacaine 0.2%

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Total Opioid-consumption	Cumulative opioid consumption : converting oral, intravenous, and patient-controlled analgesia PCA opioid to morphine equivalent	8 hours postoperative

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
NRS pain score at rest	NRS pain scores determined by patient interview, using the standard NRS of 0 to 10 scale at rest.	0,1,2,4,6,8,12,24 and 48 hours postoperative
NRS pain score during movement	NRS pain scores determined by patient interview, using the standard NRS of 0 to 10 scale, during physiotherapy.	0,1,2,4,6,8,12,24 and 48 hours postoperative
NRS pain score after 10 meters of walk or maximum walked distance	NRS pain scores determined by patient interview, using the standard NRS of 0 to 10 scale after 10 meters walk (if enable after maximum walked distance).	8, 24 and 48 hours postoperative
Ability to walk	The ability of the patient to stand up and walk 3 meters.	8, 24 and 48 hours postoperative
TUG Test	The TUG test measures the time it takes a patient to stand up from a chair, walk a distance of 3 m, and return to the chair	8, 24 and 48 hours postoperative
The 10-m walk test	time it takes the patient to walk a distance of 10 m as quickly as possible	8, 24 and 48 hours postoperative
patient satisfaction	patient interviewed, using a scale of 0-10, 0 not satisfied and 10 being the most satisfied	8, 24 and 48 hours postoperative

Collaborators and Investigators

• Sponsor: Institut Kassab d'Orthopédie

Publications and helpful links

General Publications

• Kim DH, Lin Y, Goytizolo EA, Kahn RL, Maalouf DB, Manohar A, Patt ML, Goon AK, Lee YY, Ma Y, Yadeau JT. Adductor canal block versus femoral nerve block for total knee arthroplasty: a prospective, randomized, controlled trial. Anesthesiology. 2014 Mar;120(3):540-50. doi: 10.1097/ALN.0000000000000119.

Study record dates

Study Major Dates

• Study Start: March 1, 2015
• Primary Completion (Anticipated): December 1, 2015
• Study Completion (Anticipated): December 1, 2015

Study Registration Dates

• First Submitted: March 4, 2015
• First Submitted That Met QC Criteria: March 7, 2015
• First Posted (Estimate): March 12, 2015

Study Record Updates

• Last Update Posted (Estimate): March 12, 2015
• Last Update Submitted That Met QC Criteria: March 7, 2015
• Last Verified: March 1, 2015

More Information

Terms related to this study

• Keywords: Total knee replacement; nerve block; analgesia
• Additional Relevant MeSH Terms: Physiological Effects of Drugs; Central Nervous System Depressants; Peripheral Nervous System Agents; Sensory System Agents; Anesthetics; Anesthetics, Local; Ropivacaine
• Other Study ID Numbers: P-2015002/AR