Continuous Saphenous Nerve Block for Total Knee Arthroplasty

Henning Lykke Andersen

Status: Completed

Conditions: Pain, Postoperative

Treatments: Procedure: Saline boluses in nerve catheter; Procedure: continuous saphenous nerve block

Study type: Interventional

Funder types: Other

Identifiers

NCT01332045

H-3-2010-124

Details and patient eligibility

About

Our study will compare the use of continuous saphenous nerve block performed at the adductor canal in addition to Local Infiltration Analgesia (LIA) versus a Sham block in addition to LIA for total knee replacement. The investigators hypothesize that the saphenous nerve block performed at the level of the adductor canal in addition to LIA provides better pain relief than the LIA alone without significantly compromising muscle strength and physiotherapy, enabling patients to mobilize early with reduced opioid consumption and les side effects.

The investigators will enroll a total of 40 patients (20 patients will receive continuous saphenous nerve block in addition to LIA and 20 will receive the sham block and LIA). Until discharge, the investigators will record patients' pain scores, opioid consumption, side effects and physical therapy progress.

If our study proves that the continuous saphenous nerve block in addition to LIA can effectively reduce postoperative pain scores to an acceptable level with better physical therapy progress and less opioid consumption, it could be seen as a more attractive alternative to LIA alone or other traditionally used methods of postoperative pain control that compromises muscle strength and physiotherapy.

Enrollment: 40 patients

Sex: All

Ages: 40 to 75 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• ASA I-III
• Age: 40-75
• Unilateral TKA
• Use of Spinal anesthesia

Exclusion criteria

• Allergy to any of the study medications
• Intolerance to morphine
• Contraindication to a spinal anesthetic
• Intraoperative use of any volatile anesthetic
• Chronic opioid use
• ASA Class 4-5
• Rheumatoid arthritis or Diabetes mellitus with neuropathy
• Liver or kidney failure
• BMI above 40
• Severe COPD

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Quadruple Blind

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40 participants in 2 patient groups

Saline boluses in nerve catheter

Sham Comparator group

Description:

A nerve catheter will be placed in the adductor canal using saline instead of Ropivacaine for intermittent boluses.

Treatment:

Procedure: Saline boluses in nerve catheter

Continuous saphenous nerve block

Active Comparator group

Description:

Postoperative intermittent boluses of 15 Ml Ropivacaine 7,5 mg/Ml every 12 hours for three days

Treatment:

Procedure: continuous saphenous nerve block