Comparison of Genicular Nerve Block and Intraarticular Injection for Postoperative Pain in Knee Arthroscopy

Not Applicable

Completed

• Conditions: Postoperative Pain
• Interventions: Procedure: intra-articular injection; Procedure: genicular nerve block

• Registration Number: NCT04656743
• Lead Sponsor: Tanta University

Brief Summary

This prospective double-blinded randomized study will be conducted to compare ultrasound-guided intra-articular injection and ultrasound-guided genicular nerve block for postoperative analgesia after knee arthroscopy.

Detailed Description

Arthroscopic knee surgery has become increasingly popular in modern orthopedics. Post-operative knee pain management has become a challenge to provide early relief and pain-free postoperative care to the patient.

Pain management has become a priority for management as a daycare procedure. Patients operated as a daycare procedure should have minimal postoperative pain which influences the timing of discharge. Pain is due to multifactorial causes such as irritation of free nerve endings of the joint capsule, synovial tissue, anterior fat pad.

Effective pain relief allows the patients to obtain early knee mobilization and optimal rehabilitation and thus improves patient satisfaction.

Postoperative pain after knee arthroscopy is commonly moderate to severe and can affect the patient's activity level and satisfaction.

In an effort to provide safe, effective, and long-lasting post-arthroscopy pain relief, many drug regimens were injected intra-articularly including local anesthetics alone or with additive drugs to prolong and improve the quality of postoperative analgesia.

Genicular nerve block (GNB) and ablation have been used for managing chronic pain from knee osteoarthritis with good success.

Study Timeline

• Study First Submitted: 2020-11-30
• Study First Submitted QC: 2020-11-30
• Study First Posted: 2020-12-07
• Study Start: 2020-12-10
• Primary Completion: 2024-03-01
• Status Verified: 2024-04
• Study Completion: 2024-04-15
• Last Update Submitted: 2024-04-30
• Last Update Posted: 2024-05-01

Recruitment & Eligibility

• Status: COMPLETED
• Sex: All
• Target Recruitment: 66

Inclusion Criteria

• scheduled for unilateral knee arthroscopy surgery (ligament reconstruction, cartilage procedures, and diagnostic arthroscopic procedures)
• aged between 18 and 50 years
• of both genders,
• have ASA physical status I and II.

Exclusion Criteria

• Revision knee arthroscopy,
• previous surgery or trauma to the knee,
• drug allergy,
• regular narcotic use,
• renal &/ or hepatic impairments,
• neuromuscular diseases
• and coagulopathy disorders.

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Arm && Interventions

Group	Intervention	Description
intra-articular injection group	intra-articular injection	will receive ultrasound guided intraarticular injection consisting of 20 mL of 0.25% bupivacaine before surgical procedure. The surgical procedure will be started 30 min after intraarticular injection.
genicular nerve block group	genicular nerve block	will receive ultrasound guided genicular nerve block at three nerves, i.e., superomedial, superolateral, and inferomedial genicular nerves consisting of 15 ml bupivacaine 0.25% before surgical procedure. The surgical procedure will be started 30 min after genicular nerve block.

Primary Outcome Measures

Name	Time	Method
first time of rescue analgesia	postoperative first day	first time of rescue morphine analgesia

Secondary Outcome Measures

Name	Time	Method
Number of patients received rescue analgesia.	postoperative first day	number of patients required postoperative rescue morphine analgesis
Total doses of postoperative morphine consumption	postoperative first day	Total doses of postoperative morphine consumption as rescue analgesia

Trial Locations

Locations (1)

Tarek Abdel Hay; 🇪🇬 Tanta, El Gharbyia, Egypt