Tow Techniques of Adductor Canal Block for Analgesia After Total Knee Replacement

Ultrasound-guided Continuous Adductor Canal Block for Analgesia After Total Knee Replacement: Comparison of Block at the Entrance and Middle of the Canal

This study compares the tow technique of continues adductor canal block for total knee replacement surgery. Half participants will receive catheterization at the entrance of the adductor canal, while the other half will receive catheterization at the middle point of the adductor canal.

Study Overview

• Status: Completed
• Conditions: Analgesia; Total Knee Arthroplasty; Nerve Block
• Intervention / Treatment: Procedure: ultrasound-guided short-axis placement of catheter at the entrance of the adductor canal; Procedure: ultrasound-guided long-axis placement of catheter at the middle of the adductor canal

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

Contacts and Locations

Study Locations

• China
  • Beijing, China
    • Peking Union Medical College Hospital

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
Experimental: entrance placement of adductor canal catheter	Procedure: ultrasound-guided short-axis placement of catheter at the entrance of the adductor canal; Ultrasound probe is placed at the entrance of the adductor canal in short axis ，insertion of a PAJUNK Contiplex S catheter with the tip of the catheter located at the entrance of the canal
Experimental: middle point placement of adductor canal catheter	Procedure: ultrasound-guided long-axis placement of catheter at the middle of the adductor canal; Ultrasound probe is placed at the middle of the adductor canal in long axis with the caphelad end of the probe aligned with the entrance of the canal. insertion of a PAJUNK Contiplex S catheter with the tip of the catheter located at the middle of the canal

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Time Frame
cumulative sulfentanil consumption at 24 hours after surgery	24 hours after surgery

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
the strength of quadriceps femoris	Quadriceps strength was assessed on a 0-5 scale as per the Medical Research Council Scale quadriceps motor strength(0 = no voluntary contraction possible, 1 = muscle flicker, but no movement of limb, 2 = active movement only with gravity eliminated, 3 = movement against gravity but without resistance, 4 = movement possible against some resistance and 5 = normal motor strength against resistance)	0,2,4,8,24,48 hours postoperatively
The pain scores at rest determined by the numeric rating scale (NRS, 0-10)	11-point numerical rating scale (NRS; 0, no pain; 10, maximum pain imaginable).	at 0,2,4,8,24,48 hours postoperatively
The pain scores on adduction of the keen determined by the numeric rating scale (NRS, 0-10)	11-point numerical rating scale (NRS; 0, no pain; 10, maximum pain imaginable).	at 0,2,4,8,24,48 hours postoperatively
incidence of postoperative nausea and vomiting (PONV)		within 48 hours after surgery
Patient satisfaction with anesthesia	Patient satisfaction with anesthesia was assessed using a 5-point scale (5, very satisfied; 4, satisfied; 3, neither satisfied nor dissatisfied; 2, dissatisfied; 1, very dissatisfied)	within 5th day after surgery
complications	Record complications including catheter dislodgment, puncture point infection, leakage,falling down,et al.	within 3days after surgery
cumulative sulfentanil consumption at other time points after surgery		2,4,8,48 hours postoperatively

Collaborators and Investigators

• Sponsor: Peking Union Medical College Hospital

Publications and helpful links

General Publications

• Fei Y, Cui X, Chen S, Peng H, Feng B, Qian W, Lin J, Weng X, Huang Y. Continuous block at the proximal end of the adductor canal provides better analgesia compared to that at the middle of the canal after total knee arthroplasty: a randomized, double-blind, controlled trial. BMC Anesthesiol. 2020 Oct 9;20(1):260. doi: 10.1186/s12871-020-01165-w.

Study record dates

Study Major Dates

• Study Start (Actual): May 11, 2019
• Primary Completion (Actual): December 8, 2019
• Study Completion (Actual): December 16, 2019

Study Registration Dates

• First Submitted: May 6, 2019
• First Submitted That Met QC Criteria: May 7, 2019
• First Posted (Actual): May 8, 2019

Study Record Updates

• Last Update Posted (Actual): January 2, 2020
• Last Update Submitted That Met QC Criteria: December 29, 2019
• Last Verified: December 1, 2019

More Information

Terms related to this study

• Keywords: adductor canal block
• Additional Relevant MeSH Terms: Nervous System Diseases; Neurologic Manifestations; Neurobehavioral Manifestations; Perceptual Disorders; Agnosia
• Other Study ID Numbers: CXL1

Plan for Individual participant data (IPD)

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

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No