Femoral Triangle Block: Early Mobilization and Postoperative Analgesia After Total Knee Arthroplasty

Vall d'Hebron University Hospital (HUVH)

Status: Completed

Conditions: Anesthesia, Conduction; Arthroplasty, Replacement, Knee; Ultrasonography, Interventional; Pain, Postoperative

Treatments: Procedure: Adductor Canal Block; Procedure: Apex Femoral Triangle Block; Procedure: Femoral Nerve Block

Study type: Interventional

Funder types: Other

Identifiers

NCT03518450

PR(AG)299/2017

Details and patient eligibility

About

The objective of this trial is to compare the efficacy of three different nerve blocks as an analgesic option after total knee arthroplasty (TKA), based on muscle strength, mobilization and pain.

The Adductor Canal Block has been proposed as an equally effective technique to the Femoral Nerve Block in terms of pain control after a TKA, with the benefit of preserving muscle function. We hypothesize that a block performed at the apex of the femoral triangle would best balance analgesia with quadriceps function.

Enrollment: 78 patients

Sex: All

Ages: 18 to 90 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Subjects of any gender, from 18 to 90 years old that accept to participate in the study.
• Programmed primary total knee arthroplasty surgery

Exclusion criteria

• Emergent surgery
• Reinterventions
• Unstable psychiatric pathology, dementia
• Kidney or hepatic disease that contraindicates the use of NSAIDs and/or Paracetamol.
• Allergy to amides local anesthesics, NSAIDs, opioids and/or Paracetamol.
• Daily use of opioids greater than 30 mg of morphine (or equivalent)
• Patients under 18 or over 90 years old.
• Drug abuse
• Rejection to be a participant of the study.

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Double Blind

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78 participants in 3 patient groups

Femoral Nerve Block

Active Comparator group

Description:

Ultrasound guided femoral nerve block, 30 ml of 0.25% bupivacaine and 4 mg of dexamethasone to be administered.

Treatment:

Procedure: Femoral Nerve Block

Adductor Canal Block

Active Comparator group

Description:

Ultrasound guided adductor canal block, at the proximal third of the canal, 30 ml of 0.25% bupivacaine and 4 mg of dexamethasone to be administered.

Treatment:

Procedure: Adductor Canal Block

Apex Femoral Triangle Block

Experimental group

Description:

Ultrasound guided femoral triangle block, at the distal third of the triangle, 30 ml of 0.25% bupivacaine and 4 mg of dexamethasone to be administered.

Treatment:

Procedure: Apex Femoral Triangle Block