Single Dose Adductor Canal Block vs SPANK Block for TKA

San Antonio Uniformed Services Health Education Consortium

Status: Unknown

Conditions: Pain, Acute; Pain, Postoperative; Osteo Arthritis Knee

Treatments: Procedure: Adductor Canal Block; Drug: Ropivacaine Hcl 0.5% Inj Vil 30Ml; Device: Pajunk sonoplex stim needle; Procedure: SPANK Block (Sensory Posterior Articular Nerves of the Knee)

Study type: Interventional

Funder types: Other U.S. Federal agency

Identifiers

NCT03502889

SPANK Block

Details and patient eligibility

About

This is a prospective, randomized control trial to compare SPANK block combined with adductor canal block to adductor canal block alone in treatment of post-operative pain after total knee arthroplasty. The primary outcome is pain control, which will be measured throughout the post-operative course using morphine equivalents of opioid analgesics used during the first 24 hours after surgery. Secondary outcomes include pain scores recorded at 4, 8, 12, 16, 20, and 24 hours post-operatively, cumulative pain score, incidence of post-operative nausea and vomiting, and extent of motor blockade. The study will aid in answering the question of whether SPANK block is an effective adjunct in preventing pain and decreasing opioid requirement after TKA.

Enrollment: 128 estimated patients

Sex: All

Ages: 40 to 80 years old

Volunteers: Accepts Healthy Volunteers

Inclusion criteria

• Patients between the ages of 40 and 80 years old undergoing total knee arthroplasty amenable to peripheral nerve block for perioperative analgesia.
• BMI <45
• ASA class III or less

Exclusion criteria

• Inability to sign consent form
• Allergy to medications used in the study
• Repeat surgery
• History of seizure disorder
• Simultaneous bilateral TKA
• History of substance abuse
• BMI >45
• Opioid consumption of greater or equal to 30mg morphine equivalents per day
• Age <40 or >80 years old
• ASA IV or greater
• Inability to use a PCA
• Inability to access the intrathecal space
• Infection at the site of injection (either for spinal or PNB)
• INR greater than or equal to 1.4

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: None (Open label)

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128 participants in 2 patient groups

Adductor Canal Block Alone

Active Comparator group

Description:

Control arm to receive Adductor Canal Block without additional interventions Intervention: ropivacaine 0.5% 15cc injected under ultrasound guidance

Treatment:

Device: Pajunk sonoplex stim needle

Drug: Ropivacaine Hcl 0.5% Inj Vil 30Ml

Procedure: Adductor Canal Block

SPANK Block Plus Adductor Canal Block

Experimental group

Description:

Experimental arm to receive Adductor Canal Block plus SPANK Block (Sensory Posterior Articular Nerves of the Knee) without additional interventions Intervention: ropivacaine 0.5% 15cc injected under ultrasound guidance into the adductor canal plus 20cc ropivacaine 0.5% injected into the posterior tissues of the knee

Treatment:

Device: Pajunk sonoplex stim needle

Drug: Ropivacaine Hcl 0.5% Inj Vil 30Ml

Procedure: SPANK Block (Sensory Posterior Articular Nerves of the Knee)

Procedure: Adductor Canal Block