A Randomised Controlled Trial Comparing Single Shot Adductor Canal Block With Local Infiltration Analgesia for Postoperative Analgesia After Total Knee Arthroplasty

Not Applicable

Completed

• Conditions: Analgesia in Total Knee Arthroplasty
• Interventions: Procedure: Adductor Canal Block

• Registration Number: NCT02104934
• Lead Sponsor: Changi General Hospital

Brief Summary

Total knee arthroplasty or replacement (TKA), a commonly performed surgery for osteoarthritis of the knee, is a painful procedure and requires a multimodal analgesic approach. A method for analgesia is local infiltration analgesia (LIA), where a mixture of drugs is injected around the knee joint.

Adductor canal block (ACB) is an alternative regional anaesthesia technique which has been shown to result in minimal thigh weakness.

The investigators aim to study if the analgesia provided by ACB is superior to LIA while preserving quadriceps strength.

Detailed Description

Not available

Study Timeline

• Study Start: 2014-03
• Study First Submitted: 2014-03-18
• Study First Submitted QC: 2014-04-04
• Study First Posted: 2014-04-07
• Status Verified: 2015-07
• Primary Completion: 2015-12
• Study Completion: 2016-03
• Last Update Submitted: 2017-04-24
• Last Update Posted: 2017-04-25

Recruitment & Eligibility

• Status: COMPLETED
• Sex: All
• Target Recruitment: 40

Inclusion Criteria

• Patients scheduled for primary TKA under single shot spinal anaesthesia, between ages 45-85 years old, American Society of Anesthesiologists (ASA) physical status 1 to 3 and BMI 18-35 kg/m2

Exclusion Criteria

• Patients unable to give consent, inability to communicate/ cooperate, patients with regular consumption of strong opioids (morphine, oxycodone) or steroids, allergy to local anaesthetics or any drugs included in the study, patients with lower limb surgery in the preceding year, patients with pre-existing neurological deficits and patients who have contraindications for spinal anaesthesia.

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Arm && Interventions

Group	Intervention	Description
Adductor Canal Block	Adductor Canal Block	The Adductor Canal Block group of patients will receive intravenous ketorolac 30mg intra-operatively and an adductor canal block at the end of surgery. The block will be performed under real time ultrasound guidance and 30mls of 0.5% ropivacaine (150mg) is injected with a Stimuplex A100, 21G needle.

Primary Outcome Measures

Name	Time	Method
Morphine consumption in the first 24 hours	24 hours	morphine consumption in the first 24 hours (including morphine administered in recovery and via PCA).

Secondary Outcome Measures

Name	Time	Method
Sedation Scores	Up to 48 hours
Quadriceps Strength	at 24 and 48 hours
Morphine Consumption	At 48 hours	The balance usage after primary outcome
Pain Scores	1, 6, 12, 24 hours; up to 48 hours postoperative	Pain scores are recorded at 1, 6, 12, 24 and 48 hours post-operatively, assessed using a visual analog scale (0-100mm) at rest and during 45 degree passive flexion of knee.
Postoperative Nausea and Vomiting	Up to 48 hours	Presence/absence of nausea and vomiting, and total number of episodes of vomiting

Trial Locations

Locations (1)

Changi General Hospital; 🇸🇬 Singapore, Singapore