Combined Adductor&Sciatic Nerve Block vs Femoral&Sciatic Nerve Block in Total Knee Replacement Surgery

Bakirkoy Dr. Sadi Konuk Training and Research Hospital

Status: Completed

Conditions: Orthopedic Disorder; Surgery; Post Operative Pain; Total Knee Replacement

Treatments: Procedure: Combine Femoral & Sciatic Nerve Block; Procedure: Combine Adductor Canal & Sciatic Nerve Block; Drug: Bupivacaine and prilocaine hydrochloride

Study type: Interventional

Funder types: Other

Identifiers

NCT05648708

2022-361

Details and patient eligibility

About

Knee joints, one of the largest and most functional joints of the human body, have great features to provide ideal body posture and movement. In patients with knee osteoarthritis in whom pain and functional loss continue to increase despite conservative and medical burden, they are evaluated by orthopedic surgeons for surgical treatment. Total knee replacement (TKR) surgery is aimed to eliminate the existing pain, restore and carry the movements, to protect the characteristics of the deformities and the quality of life.

Pain can be very severe after TKR surgery, which is very common in the middle and elderly patient population today. In the postoperative period, untreated pain prevents early physical therapy practices and restricts postoperative knee rehabilitation and recovery, but it also has negative effects on the respiratory, gastrointestinal, renal, and central nervous systems. Effective management of postoperative acute pain can reduce these complications and the risk of developing chronic pain.

In this study, investigators hypothesized that combined adductor canal and sciatic nerve block, applied with postoperative ultrasound guidance to patients who will undergo TKR surgery under general anesthesia, will provide effective analgesia, less opioid consumption, and faster ambulation time, similar to combined femoral and sciatic nerve block.

Full description

As a result of the power analysis investigators conducted for this study, the minimum sample size was calculated as 34 people for each group, 68 people in total, at the 95% confidence interval.

68 patients who meet the inclusion criteria will be included in our study. Patients will be randomized and divided into 2 groups. Accordingly, femoral and sciatic nerve blocks will be applied to 34 patients, and adductor canal and sciatic nerve blocks will be applied to 34 patients.

Enrollment: 68 patients

Sex: All

Ages: 40 to 85 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Ages of 40-85
• ASA I-III
• Patients who will undergo total knee replacement surgery under general anesthesia

Exclusion criteria

• Patients with deformity and pathology in the thigh region
• Clinically known local anesthetic allergy
• Clinically diagnosis of opioid, alcohol and substance dependence
• Patients who cannot perceive and evaluate pain such as psychiatric illness, mental retardation, dementia
• Morbid obesity (body mass index> 40 kg m2)

Trial design

Primary purpose: Diagnostic

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Quadruple Blind

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68 participants in 2 patient groups

Group AS

Active Comparator group

Description:

The investigators will perform an adductor canal block and sciatic nerve block on that patient group for postoperative analgesia

Treatment:

Drug: Bupivacaine and prilocaine hydrochloride

Procedure: Combine Adductor Canal & Sciatic Nerve Block

Drug: Bupivacaine and prilocaine hydrochloride

Group FS

Active Comparator group

Description:

The investigators will perform femoral and sciatic nerve blocks on that patient group for postoperative analgesia

Treatment:

Drug: Bupivacaine and prilocaine hydrochloride

Drug: Bupivacaine and prilocaine hydrochloride

Procedure: Combine Femoral & Sciatic Nerve Block