Intra-Operative Adductor Canal Blocks

Not Applicable

Recruiting

• Conditions: Knee Pain Chronic; Knee Osteoarthritis; Anesthesia; Knee Arthritis

• Registration Number: NCT05601427
• Lead Sponsor: Ottawa Hospital Research Institute

Brief Summary

Adductor canal blocks (ACB) have been recommended in total knee arthroplasty (TKA) to provide better control of post-operative pain, facilitate early ambulation, and reduce length of stay in the hospital. ACB is typically done before surgery by an anesthesiologist, which may increase time per case, cost, and requires the specialized skills of an anesthesiologist trained in regional anesthesia. Recent studies have suggested that surgeons can safely and reliably administer the adductor canal blocks (sACB) during surgery. However, there is currently very limited data on the clinical efficacy of such sACBs, and no studies assessing this technique in the context TKA that are discharged the same day. As such, this randomized control trial (RCT) is being done to compare sACBs to conventional anesthesiologist-performed adductor canal blocks (aACB).

Detailed Description

Not available

Study Timeline

• Study First Submitted: 2022-09-20
• Study First Submitted QC: 2022-10-28
• Study First Posted: 2022-11-01
• Study Start: 2023-03-22
• Status Verified: 2025-04
• Last Update Submitted: 2025-04-22
• Last Update Posted: 2025-04-25
• Primary Completion: 2025-12
• Study Completion: 2026-01

Recruitment & Eligibility

• Status: RECRUITING
• Sex: All
• Target Recruitment: 80

Inclusion Criteria

1. Male and female patients aged 18 years or older
2. Primary TKA booked as SDD
3. Diagnosis of osteoarthritis

Exclusion Criteria

1. Inability or refusal to sign informed consent form
2. Non-English or French speaking, and no licensed translator, family member or substitute decision maker available.
3. Non-osteoarthritis primary diagnosis
4. Allergy to analgesic medications
5. Contraindication to spinal and/or regional anaesthesia
6. Any use of opioid pain medication within four weeks of the index procedure(13)
7. Pain catastrophizing scale score ≥16 (8, 9, 14)
8. History of cirrhosis
9. History renal insufficiency
10. History or sensory and/or motor neuropathy to the ipsilateral limb
11. Simultaneous, bilateral TKA
12. Non-TKA prosthesis
13. Scheduled for non-SDD TKA.
14. Preoperative varus/valgus of >10 degrees.
15. Planned General Anaesthetic
16. Use of Intrathecal Morphine

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Primary Outcome Measures

Name	Time	Method
Pain medication use	When spinal anesthesia resolves until 24 hours after surgery	morphine equivalents of pain medication
Patient Report Pain	Up to 24 hours	Mean Numerical Pain Rating Scale (NPRS) scores on discharge

Secondary Outcome Measures

Name	Time	Method
Timed Up and Go Test	At discharge	Time is takes, in seconds, to stand, walk 3m, turn around, walk back 3m, and sit back down
Patient Reported Quality of Recovery	At 24 hours post-operative	Score on the Quality of Recovery-15 questionnaire
Time to discharge	From PACU to discharge	Post-operative time in minutes to discharge home
Patient Reported Function	pre-operatively, at 2 weeks post-operative	Difference in scores on the Oxford knee score (questionnaire), rated from 0-48 with 48 being the best functional outcome and 0 being the worst
Patient Reported Global Health	pre-operatively, at 2 weeks post-operative	Difference in scores on the PROMIS-10 - Global Health (questionnaire), which generates T-scores. Higher T-scores indicate better health.
Readmission Rate	Up to 24 hours post-operative	Number of patients readmitted to the hospital within 24 hours
Patient Reported Quality of Life	pre-operatively, at 2 weeks post-operative	Difference in scores on the EQ-5D-5L questionnaire (Euro Quality of Life, 5 Dimension, 5 Level), rated from 11111 - 55555, with 11111 being full health and 55555 being worst health
Admission to Hospital	Up to 24 hours post-operative	Failure to discharge home requiring admission

Trial Locations

Locations (1)

The Ottawa Hospital; 🇨🇦 Ottawa, Ontario, Canada