Prospective Comparison Between Continuous Femoral Nerve Block and the Association of Adductor Canal Block and Sciatic Nerve Block in Total Knee Arthroplasty.
Overview
- Phase
- Not Applicable
- Intervention
- Continuous femoral nerve block
- Conditions
- Neuromuscular Blockade
- Sponsor
- Institut Kassab d'Orthopédie
- Enrollment
- 80
- Primary Endpoint
- Total Opioid-consumption
- Last Updated
- 11 years ago
Overview
Brief Summary
The purpose of the study is to determine whether the association of sciatic nerve block to continuous adductor canal block is effective in the treatment of total knee arthroplasty post operative pain .
Investigators
Rais Karim
Dr
Institut Kassab d'Orthopédie
Eligibility Criteria
Inclusion Criteria
- •Elective unilateral TKA,
- •Planned continuous spinal anesthesia ,
- •Ability to follow study protocol,
- •American Society of Anesthesiologists class 1 to 3.
Exclusion Criteria
- •Contraindication for neuraxial anesthetic,
- •Chronic opioid use (defined as daily or almost daily use of opioids for \>3 months),
- •Hypersensitivity and/or allergies to any of the study medications,
- •Intraoperative use of volatile anesthetics,
- •Preexisting neuropathy on the operative limb,
- •Contraindications to a femoral, adductor canal or Tibial nerve block.
Arms & Interventions
Continous femoral nerve block
Patients will receive ultrasound-guided (USG) continuous femoral nerve block with 20 ml ropivacaine 0.2% and USG Continuous adductor canal block with 20 ml of saline and USG infragluteal SNB with 20 ml of saline .
Intervention: Continuous femoral nerve block
Continous femoral nerve block
Patients will receive ultrasound-guided (USG) continuous femoral nerve block with 20 ml ropivacaine 0.2% and USG Continuous adductor canal block with 20 ml of saline and USG infragluteal SNB with 20 ml of saline .
Intervention: Continuous adductor canal block
Continous femoral nerve block
Patients will receive ultrasound-guided (USG) continuous femoral nerve block with 20 ml ropivacaine 0.2% and USG Continuous adductor canal block with 20 ml of saline and USG infragluteal SNB with 20 ml of saline .
Intervention: infragluteal Sciatic nerve block
Continous femoral nerve block
Patients will receive ultrasound-guided (USG) continuous femoral nerve block with 20 ml ropivacaine 0.2% and USG Continuous adductor canal block with 20 ml of saline and USG infragluteal SNB with 20 ml of saline .
Intervention: Ropivacaine 0.2%
Continous femoral nerve block
Patients will receive ultrasound-guided (USG) continuous femoral nerve block with 20 ml ropivacaine 0.2% and USG Continuous adductor canal block with 20 ml of saline and USG infragluteal SNB with 20 ml of saline .
Intervention: Saline
Continuous adductor canal block
Patients will receive ultrasound-guided continuous adductor canal block with 20 ml ropivacaine 0.2% and USG infragluteal SNB with 20 ml ropivacaine 0.2% and USG continuous FNB with 20 ml of saline .
Intervention: Continuous femoral nerve block
Continuous adductor canal block
Patients will receive ultrasound-guided continuous adductor canal block with 20 ml ropivacaine 0.2% and USG infragluteal SNB with 20 ml ropivacaine 0.2% and USG continuous FNB with 20 ml of saline .
Intervention: Continuous adductor canal block
Continuous adductor canal block
Patients will receive ultrasound-guided continuous adductor canal block with 20 ml ropivacaine 0.2% and USG infragluteal SNB with 20 ml ropivacaine 0.2% and USG continuous FNB with 20 ml of saline .
Intervention: infragluteal Sciatic nerve block
Continuous adductor canal block
Patients will receive ultrasound-guided continuous adductor canal block with 20 ml ropivacaine 0.2% and USG infragluteal SNB with 20 ml ropivacaine 0.2% and USG continuous FNB with 20 ml of saline .
Intervention: Ropivacaine 0.2%
Continuous adductor canal block
Patients will receive ultrasound-guided continuous adductor canal block with 20 ml ropivacaine 0.2% and USG infragluteal SNB with 20 ml ropivacaine 0.2% and USG continuous FNB with 20 ml of saline .
Intervention: Saline
Outcomes
Primary Outcomes
Total Opioid-consumption
Time Frame: 8 hours postoperative
Cumulative opioid consumption : converting oral, intravenous, and patient-controlled analgesia PCA opioid to morphine equivalent
Secondary Outcomes
- NRS pain score at rest(0,1,2,4,6,8,12,24 and 48 hours postoperative)
- NRS pain score during movement(0,1,2,4,6,8,12,24 and 48 hours postoperative)
- patient satisfaction(8, 24 and 48 hours postoperative)
- Ability to walk(8, 24 and 48 hours postoperative)
- NRS pain score after 10 meters of walk or maximum walked distance(8, 24 and 48 hours postoperative)
- TUG Test(8, 24 and 48 hours postoperative)
- The 10-m walk test(8, 24 and 48 hours postoperative)