Postoperative Analgesic Efficacy of Ultrasound-guided Para-sartorial Compartment Block in Knee Surgery: A Randomized Study
Overview
- Phase
- Not Applicable
- Intervention
- Postoperative analgesia management
- Conditions
- Knee Osteoarthritis
- Sponsor
- Medipol University
- Enrollment
- 60
- Locations
- 1
- Primary Endpoint
- Pain scores (Numerical Rating Scale-NRS)
- Status
- Completed
- Last Updated
- 5 months ago
Overview
Brief Summary
Selective blockade of the saphenous nerve branches is among the regional anesthesia techniques in knee surgery. In this block, analgesia is provided without motor block and is an essential advantage in terms of early mobilization in the postoperative period. Blockage of motor branches causes a delay in mobilization and increases the risk of falling. The vastus medialis and its medical femoral cutaneous branch are rich in the femoral triangle. Effective postoperative analgesia is provided by a femoral triangle (triangle) blockade. The intermediate femoral cutaneous nerve courses over the sartorius muscle. Anatomically, the femoral triangle follows a separate path. When the femoral triangle and the blockade of the intermediate femoral cutaneous nerve are combined, it is called PSKB block. Parasartorial compartment block (PSKB); is based on the blockade of the branches of the saphenous nerve, the two largest sensory nerves from the femoral nerve to the knee, and is predicted to provide effective postoperative analgesia in knee arthroplasty.
Detailed Description
Selective blockade of the saphenous nerve branches is among the regional anesthesia techniques in knee surgery. In this block, analgesia is provided without motor block and is an essential advantage in terms of early mobilization in the postoperative period. Blockage of motor branches causes a delay in mobilization and increases the risk of falling. The vastus medialis and its medical femoral cutaneous branch are rich in the femoral triangle. Effective postoperative analgesia is provided by a femoral triangle (triangle) blockade. The intermediate femoral cutaneous nerve courses over the sartorius muscle. Anatomically, the femoral triangle follows a separate path. When the femoral triangle and the blockade of the intermediate femoral cutaneous nerve are combined, it is called PSKB block. Parasartorial compartment block (PSKB); is based on the blockade of the branches of the saphenous nerve, the two largest sensory nerves from the femoral nerve to the knee, and is predicted to provide adequate postoperative analgesia in knee arthroplasty. Pascarella et al. applied PSKB to a 58-year-old patient who underwent knee surgery under spinal anesthesia and had pain in the postoperative period and reported that the patient with a visual pain score of 9 decreased to 2 after the block. This study, it is aimed to evaluate the effectiveness of para-sartorial canal block for postoperative analgesia management in patients undergoing knee surgery. Our primary aim is to compare postoperative opioid consumption, and our secondary aim is to evaluate postoperative pain scores (Numerical rating scale-NRS), the presence of motor blockade, first postoperative mobilization time, and side effects (allergic reaction, nausea, vomiting, etc.) associated with opioid use.
Investigators
Bahadir Ciftci
Primary researcher
Medipol University
Eligibility Criteria
Inclusion Criteria
- •Patients with ASA classification I-III,
- •Aged 18-75 years
- •Who will be scheduled for knee surgery under spinal anesthesia.
Exclusion Criteria
- •Patients who have a history of bleeding diathesis,
- •Take anticoagulant therapy,
- •History of chronic pain before surgery,
- •Multiple trauma,
- •Who cannot assess their pain,
- •Who have been operated under spinal anesthesia,
- •Who have an infection in the area and do not accept the procedure
Arms & Interventions
Group PSCB = Parasartorial compartment block group
After placing the linear ultrasound probe in the middle of the anterior superior line to the patella and spina drug, the probe will be advanced cephalad to visualize the intermediate femoral cutaneous nerve over the satrorious. Then the block will be applied. Three injections will be made with a single needle entry in the same imaging. The procedure will be completed by applying the first injection to the femoral triangle (10 ml of local anesthetic solution), the second injection to the subsartorial region (10 ml of local anesthetic solution) lateral to the femoral artery, and the third injection to the suprasartorial region (10 ml of local anesthetic solution) (total 30 ml of 0.25% solution). concentration bupivacaine). The block location will be confirmed by injecting 2 ml of saline in every three injections.
Intervention: Postoperative analgesia management
Group C = Control group
Wound infiltration will be applied by the surgical team
Intervention: Postoperative analgesia management
Outcomes
Primary Outcomes
Pain scores (Numerical Rating Scale-NRS)
Time Frame: Changes from baseline pain scores at postoperative 8th hour
Postoperative pain assessment will be performed using the NRS score (0 = no pain, 10 = the most severe pain felt)
Secondary Outcomes
- Adverse events will be recorded(Postoperative 24 hours period)
- Rescue analgesia (Opioid-tramadol consumption)(Changes from baseline opioid consumption at postoperative 1, 2, 4, 8, 16 and 24 hours.)