Epidural Analgesia vs Adductor Canal Block in Bilateral TKA

Mahidol University

Status: Completed

Conditions: Osteo Arthritis Knee

Treatments: Procedure: Bilateral single-shot bilateral adductor canal blocks; Procedure: Continuous epidural block

Study type: Interventional

Funder types: Other

Identifiers

NCT03205540

Si 245/2017

Details and patient eligibility

About

This study evaluates postoperative analgesic efficacy within 48 hours between epidural analgesia and single-shot bilateral adductor canal blocks in bilateral total knee arthroplasty. Half of participants will be received continuous epidural analgesia, while other half of participants will be received single-shot bilateral adductor canal blocks.

Full description

Continuous epidural analgesia is effective postoperative pain control but it has some limitations in patients with hypotension, concurrent anticoagulants, technical difficulty, urinary retention.

Adductor canal block is less invasive than continuous epidural analgesia. It provides effective analgesia for total knee arthroplasty and preserves quadriceps muscle strength.

Enrollment: 70 patients

Sex: All

Ages: 18+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Aged more than 18 years old undergoing bilateral total knee arthroplasty
• American Society of Anesthesiologists physical status classification 1-3

Exclusion criteria

• Participants deny to enroll the study
• Allergy to bupivacaine
• Weight less than 50 kilograms
• Hepatic disease
• Contraincation for neuraxial block or adductor canal block
• Uncontrolled cardiovascular disease
• Creatinine clearance less than 50 ml/min

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Double Blind

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70 participants in 2 patient groups

Epidural analgesia

Experimental group

Description:

Lumbar continuous epidural block

Treatment:

Procedure: Continuous epidural block

Bilateral ACB

Experimental group

Description:

Ultrasound-guided bilateral adductor canal blocks

Treatment:

Procedure: Bilateral single-shot bilateral adductor canal blocks