Regional Anesthesia in TKA: Impact on Postoperative Joint Motion and Patient Satisfaction

Konya City Hospital

Status: Enrolling

Conditions: Postoperative Pain; Knee Range of Motion; Patient Satisfaction; Total Knee Arthroplasty; Regional Anesthesia

Treatments: Procedure: Regional anethesia

Study type: Interventional

Funder types: Other

Identifiers

NCT07124494

Study Epidural

Details and patient eligibility

About

This is a single-center, prospective, randomized controlled trial aiming to evaluate the effects of different regional anesthesia/analgesia techniques on postoperative knee range of motion (ROM) and patient satisfaction following total knee arthroplasty (TKA). Ninety patients undergoing elective TKA under spinal anesthesia will be randomly assigned to one of three groups: 1) spinal anesthesia with epidural catheter, 2) spinal anesthesia followed by adductor canal catheterization, and 3) spinal anesthesia with multimodal intravenous analgesia. The primary outcome is postoperative knee joint ROM measured on postoperative days 1, 2, and 3. Secondary outcomes include patient satisfaction, Oxford Knee Score, postoperative opioid consumption, and VAS scores. The study is conducted at Konya City Hospital and will be completed over a 6-month period.

Enrollment: 30 estimated patients

Sex: All

Ages: 18+ years old

Volunteers: No Healthy Volunteers

Inclusion and exclusion criteria

• Minimum Age: 18 Years

• Maximum Age: None

• Sex: All

• Gender Based: No

• Accepts Healthy Volunteers: No

• Inclusion Criteria:

  • Scheduled for primary total knee arthroplasty
  • Age ≥ 18 years
  • American Society of Anesthesiologists (ASA) physical status I-III
  • Accepting neuraxial anesthesia

• Exclusion Criteria:

  • Skin infection at the planned injection site
  • Sepsis
  • Coagulopathy
  • Refusal of neuraxial anesthesia
  • Severe hypovolemia
  • Demyelinating central nervous system disease
  • Age under 18 years
  • Illiterate in Turkish
  • Non-cooperative patients
  • Known allergy or hypersensitivity to bupivacaine

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Double Blind

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30 participants in 3 patient groups

Combined Spinal-Epidural Anesthesia

Active Comparator group

Description:

Postoperative analgesia will be provided via epidural catheter with programmed infusion of bupivacaine .

Treatment:

Procedure: Regional anethesia

Adductor Canal Block

Active Comparator group

Description:

Ultrasound-guided adductor canal catheter placement and continuous infusion of bupivacaine .

Treatment:

Procedure: Regional anethesia

Multimodal Intravenous Analgesia

Sham Comparator group

Description:

Continuous intravenous tramadol infusion with rescue analgesia as required.

Treatment:

Procedure: Regional anethesia