Comparison of Continuous Femoral Nerve Block and Adductor Canal Block After Total Knee Replacement Therapy

Philipps University

Status: Completed

Conditions: Femoral Nerve Block; Adductor Canal Block; Total Knee Arthroplasty; Total Knee Replacement

Treatments: Drug: Ropivacaine

Study type: Interventional

Funder types: Other

Identifiers

NCT02125903

AZ 06/13

Details and patient eligibility

About

The blockade of the femoral nerve (FNB) is the most common postoperative pain therapy after total knee replacement. Because of motor-driven weakness of the quadriceps muscle induced by femoral nerve block mobilization of Patients is difficult even dangerous (falls) and hospital stays are extended.

An alternative method could be an adductor canal block (ACB). Anatomical studies of the adductor canal demonstrated that the adductor canal contains the saphenous nerve, a pure sensory nerve for medial and anterior aspects of the knee and the tibia without any motor function.

This prospective, double-blinded, randomized study investigates the effect of FNB and ACB on quadriceps motor weakness and analgesia determined by Numeric Rating Scale (NRS).

We expect the ACB to be superior in muscle strength but equal in pain score. Both groups receive an additional anterior sciatic nerve block for complete sensory block of the operated knee

Enrollment: 44 patients

Sex: All

Ages: 50 to 80 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• patients with knee replacement therapy and general anaesthesia
• informed consent
• preoperative "timed up and go" test performable

Exclusion criteria

• emergency patients
• BMI > 40 kg/m2
• American Society of Anaesthesiologists physical status (ASA) 4-5
• severe chronic obstructive pulmonary disease (COPD)
• rheumatic arthritis, diabetic Polyneuropathy, M. Parkinson
• nerve injury of lumbosacral plexus
• coagulopathy with bleeding tendency
• not capable of speaking or understanding german or english

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Double Blind

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44 participants in 2 patient groups

Continuous Adductor Canal Block (CACB)

Active Comparator group

Description:

Continuous Adductor Canal block performed with: loading dose 0,375% Ropivacaine 15ml (56,25mg) start infusion 0,2% Ropivacaine 6ml/h Procedure: Femoral Nerve Block. Adductor Canal Block Drug: Ropivacaine

Treatment:

Drug: Ropivacaine

Continuous Femoral Nerve Block (CFNB)

Active Comparator group

Description:

Continuous Femoral Nerve Block performed with: loading dose 0,375% Ropivacaine 15ml (56,25mg) start infusion 0,2% Ropivacaine 6ml/h Procedure: Femoral Nerve Block. Adductor Canal Block Drug: Ropivacaine

Treatment:

Drug: Ropivacaine