Addition of Popliteal Plexus Block to Continuous Femoral Nerve Block for Total Knee Arthroplasty

University Hospitals (UH)

Status: Unknown

Conditions: Pain, Postoperative

Treatments: Drug: Ropivacaine 0.5% Injectable Solution

Study type: Interventional

Funder types: Other

Identifiers

NCT04048889

2019-00655

Details and patient eligibility

About

The popliteal plexus block has been described as an alternative analgesic postoperative pain treatment for total knee arthroplasty. It consists of injecting local anaeshetics inside the distal end of the adductor canal close to the adductor hiatus, adjacent to the femoral artery, between the medial vastus muscle and the adductor magnus muscle, in order to anesthetize the popliteal plexus. However, the analgesic efficacy has never been demonstrated in a randomized controlled trial. Therefore the objective of this study is to investigate the analgesic benefit of this block combined with a continuous femoral nerve block, on patients scheduled for total knee athroplasty.

Full description

Patients scheduled to undergo total knee arthroplasty under general anesthesia will be randomly allocated to two groups: continuous femoral nerve block alone or continuous femoral nerve block with addition of a popliteal plexus block.

The continuous femoral nerve block will be performed by the anesthesiologist with 15 mLs of ropivacaine 0.5%, under ultrasound guidance before the beginning of the general anesthesia. The popliteal plexus block will be done by the anesthesiology, under ultrasound guidance, before the beginning of the surgery, under general anesthesia.

Postoperative analgesia will include acetaminophen (4 x 1000 mg), ibuprofen (3 x 400 mg) and a continuous infusion of Ropivacaine 0.2%.

Enrollment: 66 estimated patients

Sex: All

Ages: 18+ years old

Volunteers: Accepts Healthy Volunteers

Inclusion criteria

• Patients scheduled for total knee athroplasty under general anesthesia
• ASA 1-3

Exclusion criteria

• Kidney disease with GFR < 50 ml/mn
• Daily opioid consumption > 1 month
• Allergy to local anesthetics
• Neurological problems of the lower extremity
• other contraindications to peripheral nerve blocks

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Triple Blind

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66 participants in 2 patient groups

Popliteal plexus block and continuous femoral nerve block

Experimental group

Treatment:

Drug: Ropivacaine 0.5% Injectable Solution

Drug: Ropivacaine 0.5% Injectable Solution

Drug: Ropivacaine 0.5% Injectable Solution

continuous femoral nerve block

Active Comparator group

Treatment:

Drug: Ropivacaine 0.5% Injectable Solution

Drug: Ropivacaine 0.5% Injectable Solution

Drug: Ropivacaine 0.5% Injectable Solution