Comparison of Genicular Nerve Block and Intraarticular Injection for Postoperative Pain in Knee Arthroscopy

Tanta University

Status: Completed

Conditions: Postoperative Pain

Treatments: Procedure: intra-articular injection; Procedure: genicular nerve block

Study type: Interventional

Funder types: Other

Identifiers

NCT04656743

pain in knee arthroscopy

Details and patient eligibility

About

This prospective double-blinded randomized study will be conducted to compare ultrasound-guided intra-articular injection and ultrasound-guided genicular nerve block for postoperative analgesia after knee arthroscopy.

Full description

Arthroscopic knee surgery has become increasingly popular in modern orthopedics. Post-operative knee pain management has become a challenge to provide early relief and pain-free postoperative care to the patient.

Pain management has become a priority for management as a daycare procedure. Patients operated as a daycare procedure should have minimal postoperative pain which influences the timing of discharge. Pain is due to multifactorial causes such as irritation of free nerve endings of the joint capsule, synovial tissue, anterior fat pad.

Effective pain relief allows the patients to obtain early knee mobilization and optimal rehabilitation and thus improves patient satisfaction.

Postoperative pain after knee arthroscopy is commonly moderate to severe and can affect the patient's activity level and satisfaction.

In an effort to provide safe, effective, and long-lasting post-arthroscopy pain relief, many drug regimens were injected intra-articularly including local anesthetics alone or with additive drugs to prolong and improve the quality of postoperative analgesia.

Genicular nerve block (GNB) and ablation have been used for managing chronic pain from knee osteoarthritis with good success.

Enrollment: 66 patients

Sex: All

Ages: 18 to 50 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• scheduled for unilateral knee arthroscopy surgery (ligament reconstruction, cartilage procedures, and diagnostic arthroscopic procedures)
• aged between 18 and 50 years
• of both genders,
• have ASA physical status I and II.

Exclusion criteria

• Revision knee arthroscopy,
• previous surgery or trauma to the knee,
• drug allergy,
• regular narcotic use,
• renal &/ or hepatic impairments,
• neuromuscular diseases
• and coagulopathy disorders.

Trial design

Primary purpose: Prevention

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Triple Blind

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66 participants in 2 patient groups

intra-articular injection group

Experimental group

Description:

will receive ultrasound guided intraarticular injection consisting of 20 mL of 0.25% bupivacaine before surgical procedure. The surgical procedure will be started 30 min after intraarticular injection.

Treatment:

Procedure: intra-articular injection

genicular nerve block group

Experimental group

Description:

will receive ultrasound guided genicular nerve block at three nerves, i.e., superomedial, superolateral, and inferomedial genicular nerves consisting of 15 ml bupivacaine 0.25% before surgical procedure. The surgical procedure will be started 30 min after genicular nerve block.

Treatment:

Procedure: genicular nerve block