comparison of Pain relief after total knee replacement surgery between adductor canal block and local intraarticular infiltration

Completed

Brief Summary: In conclusion, in patients undergoing elective unilateral total knee arthroplasty(TKA), adductor canal block(ACB) was found to be superior to both local intraarticular infiltration and control group in reducing the 24 hour morphine consumption, lowering VAS scores at rest and with movement, prolonging time to first analgesia, reducing requirement of rescue analgesia, lowering worst VAS score during timed up and go test(TUG test) and showing better patient satisfaction scores. The incidence of opioid-related side-effects was comparable among the three groups. Adductor canal block also was not associated with any complications related to its technique, hence ACB can be considered a safe technique to be used in patients undergoing unilateral TKA for postoperative analgesia. While local intra-articular infiltration was found to be superior to control group in reducing 24 hour PCA morphine consumption, lowering VAS scores both at rest and with movement, prolonging time to first analgesia, reducing the requirement of rescue analgesia and showing better patient satisfaction compared to control group.

Recruitment & Eligibility

Inclusion Criteria

ASA physical status I-III scheduled for elective primary unilateral knee arthroplasty.

Exclusion Criteria

1.Age > 80 years 2.ASA IV / V 3.Bilateral / Revision TKA 4.Morbid obesity (BMI â‰¥ 40 ) 5.History of focal neurological deficit 6.History of sensory or motor disorders of limb to be operated 7.History of allergy to local anaesthetics , clonidine 8.History of regular opioid use 9.Local site infection 10.Patient refusal to partake in the study.
11.Contraindication to spinal anaesthesia.

Primary Outcome Measures

Name	Time	Method
To estimate the total morphine consumption in the three groups	24 hours postopertively

Secondary Outcome Measures

Name	Time	Method
To assess pain scores at rest and movement using visual analogue scale	0,4,8,12,24 hours postoperatively
To estimate the time to first use of patient controlled analgesia device	24 hours postoperatively
To compare the side effects associated with morphine consumption in the three groups	24 hours postoperatively
To estimate the worst pain during and time taken to perform the timed get up and go (TUG) test	24 hours postoperatively
To assess patient satisfaction	24 hours postoperatively

Locations (1): AIIMS New delhi
🇮🇳
South, DELHI, India
AIIMS New delhi
🇮🇳South, DELHI, India
DrMagesh
Principal investigator
9013078163
magesh.268@gmail.com