Continuous Adductor Canal Block for Total Knee Arthroplasty Analgesia

Not Applicable

• Conditions: Neuromuscular Blockade; Pain Management
• Interventions: Procedure: Continuous femoral nerve block; Procedure: Continuous adductor canal block; Procedure: infragluteal Sciatic nerve block; Drug: Ropivacaine 0.2%; Drug: Saline

• Registration Number: NCT02387021
• Lead Sponsor: Institut Kassab d'Orthopédie

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 .

Detailed Description

Not available

Study Timeline

• Status Verified: 2015-03
• Study Start: 2015-03
• Study First Submitted: 2015-03-04
• Study First Submitted QC: 2015-03-07
• Last Update Submitted: 2015-03-07
• Study First Posted: 2015-03-12
• Last Update Posted: 2015-03-12
• Primary Completion: 2015-12
• Study Completion: 2015-12

Recruitment & Eligibility

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

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.

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Arm && Interventions

Group	Intervention	Description
Continous femoral nerve block	infragluteal Sciatic 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 .
Continous femoral nerve block	Ropivacaine 0.2%	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 .
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 .
Continous femoral nerve block	Saline	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 .
Continuous adductor canal block	Continuous femoral nerve 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 .
Continuous adductor canal block	Saline	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 .
Continous femoral nerve block	Continuous 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 .
Continous femoral nerve block	Continuous adductor canal 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 .
Continuous adductor canal block	infragluteal Sciatic nerve 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 .
Continuous adductor canal block	Ropivacaine 0.2%	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 .

Primary Outcome Measures

Name	Time	Method
Total Opioid-consumption	8 hours postoperative	Cumulative opioid consumption : converting oral, intravenous, and patient-controlled analgesia PCA opioid to morphine equivalent

Secondary Outcome Measures

Name	Time	Method
NRS pain score at rest	0,1,2,4,6,8,12,24 and 48 hours postoperative	NRS pain scores determined by patient interview, using the standard NRS of 0 to 10 scale at rest.
NRS pain score during movement	0,1,2,4,6,8,12,24 and 48 hours postoperative	NRS pain scores determined by patient interview, using the standard NRS of 0 to 10 scale, during physiotherapy.
patient satisfaction	8, 24 and 48 hours postoperative	patient interviewed, using a scale of 0-10, 0 not satisfied and 10 being the most satisfied
Ability to walk	8, 24 and 48 hours postoperative	The ability of the patient to stand up and walk 3 meters.
NRS pain score after 10 meters of walk or maximum walked distance	8, 24 and 48 hours postoperative	NRS pain scores determined by patient interview, using the standard NRS of 0 to 10 scale after 10 meters walk (if enable after maximum walked distance).
TUG Test	8, 24 and 48 hours postoperative	The TUG test measures the time it takes a patient to stand up from a chair, walk a distance of 3 m, and return to the chair
The 10-m walk test	8, 24 and 48 hours postoperative	time it takes the patient to walk a distance of 10 m as quickly as possible