Ultrasound-guided Continuous Adductor Canal Block for Analgesia After Total Knee Replacement: Comparison of Short-axis and Long-axis Techniques

This study compares the long-axis and short-axis technique of continues adductor canal block for total knee replacement surgery. Half participants will receive long-axis catheterization, while the other half will receive short-axis catheterization.

Study Overview

• Status: Completed
• Conditions: Analgesia; Total Knee Arthroplasty; Nerve Block
• Intervention / Treatment: Procedure: ultrasound guided short axis placement of adductor canal catheter; Device: Philip CX 50 Ultrasound Scanner; Device: PAJUNK Contiplex S Catheter; Drug: Ropivocaine; Drug: rescue sulfentanil given postoperatively as PICA; Procedure: ultrasound guided long axis placement of adductor canal catheter

• Study Type: Interventional
• Enrollment (Actual): 62
• Phase: Not Applicable

Contacts and Locations

Study Locations

• China
  • Beijing
    • Beijing, Beijing, China, 100730
      • Xulei CUI

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years to 80 years (Adult, Older Adult)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

Description

Inclusion Criteria:

• 18-80 years
• Knee-arthroscopy
• Written consent
• ASA I-III
• BMI 19-35

Exclusion Criteria:

• Unable to communicate with the investigators (e.g., a language barrier or a neuropsychiatric disorder).
• coagulopathy or on anticoagulant medication
• Allergic reactions toward drugs used in the trial
• History of substance abuse
• Infection at injection site
• Can not be mobilised to 5 meters of walk pre-surgery

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Supportive Care
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: Triple

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Active Comparator: short axis (SAX) placement of adductor canal catheters; Procedure: Ultrasound guided short axis (SAX) placement of adductor canal catheters Philip CX50 ultrasound scanner guided insertion of a PAJUNK Contiplex S catheter along the short axis of the middle part of adductor canal	Procedure: ultrasound guided short axis placement of adductor canal catheter; The long axis of the ultrasound probe is placed vertical to the long axis of the adductor canal while scanning, and the catheter is placed along the short axis of the canal using an in-plane approach; Device: Philip CX 50 Ultrasound Scanner; The linear (C5-12) probe of Philip CX 50 Ultrasound Scanner is used for scanning; Device: PAJUNK Contiplex S Catheter; Drug: Ropivocaine; 0.2% ropivacaine 10ml is given as loading dose. Following that, 0.2% ropivacaine 5ml/h is given as maintenance dose.; Drug: rescue sulfentanil given postoperatively as PICA; bolus: 2mg, lock time: 10min, 1h limitation: 8mg
Experimental: long axis (LAX) placement of adductor canal catheters; Procedure: Ultrasound guided long axis (LAX) placement of adductor canal catheters Philip CX50 ultrasound scanner guided insertion of a catheter along the long axis of the middle part of adductor canal	Device: Philip CX 50 Ultrasound Scanner; The linear (C5-12) probe of Philip CX 50 Ultrasound Scanner is used for scanning; Device: PAJUNK Contiplex S Catheter; Drug: Ropivocaine; 0.2% ropivacaine 10ml is given as loading dose. Following that, 0.2% ropivacaine 5ml/h is given as maintenance dose.; Drug: rescue sulfentanil given postoperatively as PICA; bolus: 2mg, lock time: 10min, 1h limitation: 8mg; Procedure: ultrasound guided long axis placement of adductor canal catheter; The long axis of the ultrasound probe is placed parallel to the long axis of the adductor canal while scanning, and the catheter is placed along the long axis of the canal using an in-plane approach

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
the strength of quadriceps femoris	strength of quadriceps femoris measured on a Lovett muscle strength rating-scale within 48 hours after surgery	within 48hours after surgery

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
postoperative nausea and vomiting score	Rating-scale 0-3 SAX-group vs. LAX-group	0-2, 2-4, 4-8, 8-24, 24-48 hours postoperative
ambulation time	SAX-group vs. LAX-group	within the 7 days after surgery
quality of recovery	use the self-assessment 11item QoR scale to assess the patient's recovery quality,SAX-group vs. LAX-group	3days and 7days after surgery
complications	Record complications including catheter dislodgment, puncture point infection, leakage,falling down,et al.	within the 7 days after surgery
the strength of quadriceps femoris	SAX-group vs. LAX-group	0,2,4,8,24,48 hours postoperative
Pain-score (VAS), patient at rest	Pain-score measured on a Visual Analog Scale (VAS) .SAX-group vs. LAX-group	0,2,4,8,24,48 hours postoperative
Pain-score (VAS), motion pain	Pain-score measured on a Visual Analog Scale (VAS) .SAX-group vs. LAX-group	0,2,4,8,24,48 hours postoperative
sulfentanil consumption	record the amount（ml) of sulfentanil used	0,2,4,8,24,48 hours postoperative

Collaborators and Investigators

• Sponsor: Cui Xulei
• Collaborators: Medical Consulting Center
• Investigators: Study Chair: Yuguang Huang, MD, Peking Union Medical College Hospital

Study record dates

Study Major Dates

• Study Start (Actual): July 1, 2016
• Primary Completion (Actual): February 3, 2018
• Study Completion (Actual): April 18, 2018

Study Registration Dates

• First Submitted: June 7, 2016
• First Submitted That Met QC Criteria: June 11, 2016
• First Posted (Estimate): June 15, 2016

Study Record Updates

• Last Update Posted (Actual): April 16, 2019
• Last Update Submitted That Met QC Criteria: April 15, 2019
• Last Verified: April 1, 2019

More Information

Terms related to this study

• Keywords: adductor canal block
• Additional Relevant MeSH Terms: Physiological Effects of Drugs; Central Nervous System Depressants; Peripheral Nervous System Agents; Analgesics; Sensory System Agents; Anesthetics, Intravenous; Anesthetics, General; Anesthetics; Analgesics, Opioid; Narcotics; Adjuvants, Anesthesia; Sufentanil; Dsuvia
• Other Study ID Numbers: cuixulei1

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: No