Ambulatory Continuous Adductor Canal Block to Facilitate Same Day Discharge Following Total Knee Arthroplasty: A Pilot Study

Lawson Health Research Institute

Status: Completed

Conditions: Knee Osteoarthritis

Treatments: Procedure: Adductor canal block

Study type: Interventional

Funder types: Other

Identifiers

NCT02228759

105097

Details and patient eligibility

About

Patients scheduled to undergo total knee arthroplasty will receive motor sparing knee blocks with continuous adductor canal block along with multimodal analgesia started pre-operatively and continued into the postoperative period. The study will evaluate the feasibility of home discharge within the first 24 hours following total knee arthroplasty. We will also evaluate the pain scores in the first 5 days following the surgery, causes of delayed discharge and any adverse events.

Enrollment: 25 patients

Sex: All

Ages: 40 to 70 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

1. Male and females of 40-70years of age
2. Scheduled to undergo unilateral primary total knee arthroplasty
3. ASA Class I, II

Exclusion criteria

1. ASA 3, 4
2. Revision surgery
3. Narcotic dependent (opioid intake morphine equivalent > 10 mg/ day for more than 3 months)
4. Other sources of chronic pain like fibromyalgia
5. Patients with associated significant cardiac, CNS or respiratory disease (poor cardio-respiratory reserve)
6. Major conduction defects in EKG (bifascilular block, CHB); significant valvular heart disease
7. Recent MI/ Stroke/ CHF (in the past 3 months)
8. BMI> 35
9. Obstructive sleep apnea (AHI > 15)
10. Patients with coexisting hematological disorder or with deranged coagulation parameters.
11. Patients with pre-existing major organ dysfunction such as hepatic and renal failure.
12. Psychiatric illnesses
13. Uncontrolled diabetes mellitus
14. Lack of informed consent.
15. Allergy to any of the drugs used in the study
16. Preoperative neurological deficits
17. Use of walking aids preoperatively
18. Living alone (Lack of Chaperone/home help)
19. Language barrier
20. Contralateral leg weakness
21. Pregnancy

Trial design

Primary purpose: Supportive Care

Allocation: N/A

Interventional model: Single Group Assignment

Masking: None (Open label)

---

25 participants in 1 patient group

Adductor canal block

Experimental group

Description:

The study is an open label pilot study to determine the feasibility of same day discharge following total knee arthroplasty with the use of a fast track regimen employing motor sparing knee blocks. The study will be performed on 25 American Society of Anesthesiologists class (ASA) 1-2 patients satisfying the inclusion criteria and undergoing unilateral primary total knee arthroplasty. First and second patients of the day undergoing surgery between Monday to Thursday in a week will be accessed for the study.

Treatment:

Procedure: Adductor canal block