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Effect of LIA on Postoperative Pain Following ACL Reconstruction

Not Applicable
Conditions
Pain, Postoperative
Anterior Cruciate Ligament Rupture
Interventions
Procedure: local infiltration analgesia
Registration Number
NCT03873077
Lead Sponsor
Algemeen Ziekenhuis Maria Middelares
Brief Summary

An anterior cruciate ligament (ACL) rupture is one of the most common sport injuries, which typically develops after a sudden knee torsion. Arthroscopic repair of the ACL is often required as a complete ACL tear can cause instability of the knee joint.

During arthroscopic reconstruction the lower leg is reattached to the upper leg using part of the hamstring tendon (mm. gracilis and mm. semitendinosus). Optimal postoperative analgesia is necessary to allow a quick recovery. Intravenous analgesia during surgery is often associated with a number of side effects such as nausea, vomiting and muscle weakness and does not anesthetize the donor site of the hamstring tendon graft. Local infiltration of ropivacaine and lidocaine in the knee joint and at the donor site can be a valuable asset to control the postoperative pain.

This study evaluates the effect of local infiltration analgesia (LIA) on the postoperative pain in the first month after an ACL reconstruction. Half of participants will only receive intravenous analgesia during surgery, the other half will receive intravenous analgesia and a LIA.

Detailed Description

2 x 20 patients which are planned for arthroscopic ACL reconstruction are randomised: standard-group and LIA-group.

All patients receive standardised multimodal intravenous analgesia. After standardised induction of anesthesia, patient positioning and administration of basic analgetics (paracetamol, diclofenac, clonidine and morfine), patients in the LIA-group receive a local infiltration in the knee of 10 mL ropivacaine and 10 mL lidocaine.

Visual Analogue Scores are assessed 15 minutes after awakening from surgery and on Day 1, 2, 3, 7, 14, 21 and 28 after surgery. Postoperative analgesic consumption are registered in the first month after the surgery. The quality of recovery after anesthesia is assessed on Day 1 by the postoperative quality of recovery score (QoR-15).

Recruitment & Eligibility

Status
UNKNOWN
Sex
All
Target Recruitment
40
Inclusion Criteria
  • elective arthroscopic anterior cruciate ligament reconstruction
  • adult
Exclusion Criteria
  • unwilling or unable to grant written informed consent
  • revisions
  • contra-indication for ropivacaine

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
intravenous analgesia + LIAlocal infiltration analgesiaPatient receives intravenous analgesia and a local infiltration analgesia in the knee
Primary Outcome Measures
NameTimeMethod
Visual Analogue Scale for painFrom moment of surgery until one month after surgery

Pain intensity using the VAS (where 0 = no pain and 100 = pain as bad as can be) 15 minutes after awakening and on Day 1, 2, 3, 7, 14, 21 and 28 after surgery.

Secondary Outcome Measures
NameTimeMethod
Postoperative analgesia consumptionFrom moment of surgery until one month after surgery

Dosing and frequency of analgesia consumption

General patient comfortFrom moment of surgery until one day after surgery

Quality of recovery score (QoR-15) on the first day after surgery

Incidence of nausea and vomitingFrom moment of surgery until hospital discharge (one day after surgery)

Incidence of postoperative nausea and vomiting

PONV treatmentFrom moment of surgery until hospital discharge (one day after surgery)

Number of pharmacological treatments for postoperative nausea and vomiting (PONV)

Trial Locations

Locations (1)

General Hospital Maria Middelares

🇧🇪

Ghent, Oost-Vlaanderen, Belgium

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