Comparison of Regional Anesthesia Techniques After Total Knee Arthroplasty

Medical University of Lublin

Status: Completed

Conditions: Postoperative Pain; Pain, Acute; Mobility Limitation; Knee Arthropathy

Treatments: Procedure: Spinal anesthesia; Procedure: continuous anesthesia of adductor canal; Procedure: continuous anesthesia of femoral nerve

Study type: Interventional

Funder types: Other

Identifiers

NCT03143738

KE-0254/188/2016

Details and patient eligibility

About

Comparison of continuous adductor canal block to continuous femoral nerve block in patients after total knee arthroplasty.

All patients will be anesthetized with spinal anesthesia. Continuous infusion of ropivacaine with a catheter implemented to the adductor canal or next to the femoral nerve.

The observed goals: pain intensity, the beginning and quality of rehabilitation.

Full description

Written consent will be obtained a day before the surgery. Only subarachnoidally anaesthetised patients may participate in the study. Pencil-point spinal needle and bupivacaine (Marcaine Heavy Spinal 0.5 %) will be used.

Before the beginning of operation, under ultrasound control, a catheter will be implemented to one of the chosen position: the adductor canal (the middle or lower third of thigh) or near the femoral nerve (below the inguinal ligament). The local anesthetic solution of 0.2 % ropivacaine will be started with an elastomeric pump (5 mL per hour, up to 72 hours) as soon as a catheter in the right position.

The pain will be measured with VAS (visual-analogue scale) 8, 24 and 48 hours after the end of operation, and at the discharge. At the same time, i.e.: 8, 24 and 48 hours from the end of surgery, the range of flexion and extension in the operated knee will be assessed. Moreover, the possibility of patient's sitting, standing up and walking will be noted.

All parameters will be reassessed before patients' discharge from the hospital. Each patient will receive paracetamol (1.0) and metamizol (1.0) intravenously (i.v.) q6h. 5 mg of morphine may be given as required, up to 2 dosages per day as a rescue medication.

Enrollment: 100 patients

Sex: All

Ages: 18 to 80 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• knee arthroplasty
• obtained consent
• subarachnoid anaesthesia

Exclusion criteria

• coagulopathy
• allergy to to local anesthetics
• depression, antidepressant drugs treatment
• epilepsy
• usage of painkiller before surgery
• addiction to alcohol or recreational drugs

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Single Blind

---

100 participants in 2 patient groups

continuous anesthesia of adductor canal

Experimental group

Treatment:

Procedure: Spinal anesthesia

Procedure: continuous anesthesia of adductor canal

continuous anesthesia of femoral nerve

Experimental group

Treatment:

Procedure: Spinal anesthesia

Procedure: continuous anesthesia of femoral nerve