Early Discharge in Patients Undergoing Elbow Arthroscopy

University Health Network, Toronto

Status: Completed

Conditions: Elbow Arthroscopy Surgery

Treatments: Other: Early Discharge; Other: Normal Discharge; Procedure: Elbow arthroscopy with infraclavicular nerve block and continuous local anesthetic infusion to day 3 post op.

Study type: Interventional

Funder types: Other

Identifiers

NCT01151241

10-0120-A

Details and patient eligibility

About

Patients undergoing elbow arthroscopy surgery will receive standard anesthesia and analgesia (infraclavicular nerve block combined with general anesthesia for surgery; continuous infusion via infraclavicular catheter to day 3 post op). Patients in the experimental group will be discharged home after one day, with infraclavicular catheter in place; patients in the comparator group will stay in hospital for 3 or 4 days, per standard practice. The study will compare range of motion as the primary endpoint, in a non-inferiority design, to see if early discharge is feasible while providing similar recovery.

Enrollment: 40 patients

Sex: All

Ages: 18 to 65 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Patients undergoing elective complex arthroscopic elbow surgery requiring postoperative CPM - synovectomy, capsulectomy, extensive debridement, contracture release, osteocapsular arthroplasty.
• ASA I-III

Exclusion criteria

• Age>65
• Cognitively challenged patients
• Severe COPD
• Patients who, on their own or with the assistance of a caregiver, are not confident of being able to remove the local anesthetic infusion catheter at home
• Psychiatric history
• Allergy to ropivacaine.
• Opioid tolerance (>60mg oral morphine or equivalent/day)

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: None (Open label)

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40 participants in 2 patient groups

Early discharge

Experimental group

Description:

Patients will be discharged home on the first day after surgery, with infraclavicular catheter infusion of local anesthetic in place.

Treatment:

Procedure: Elbow arthroscopy with infraclavicular nerve block and continuous local anesthetic infusion to day 3 post op.

Other: Early Discharge

Normal Discharge

Active Comparator group

Description:

Patients will remain in hospital and be discharged per current discharge criteria, once the infraclavicular catheter has been removed on day 3 post op. Typical discharge occurs on day 3 or 4 post op.

Treatment:

Procedure: Elbow arthroscopy with infraclavicular nerve block and continuous local anesthetic infusion to day 3 post op.

Other: Normal Discharge