Local Infiltration Analgesia vs Adductor Canal Block for Analgesia After Anterior Cruciate Ligament Reconstruction
- Conditions
- Rupture of Anterior Cruciate LigamentInfiltrationRegional Anesthesia Morbidity
- Interventions
- Registration Number
- NCT02524652
- Lead Sponsor
- Centre Hospitalier Universitaire Vaudois
- Brief Summary
Early rehabilitation after anterior cruciate ligament reconstruction is of paramount importance and requires optimal pain control based on a multimodal concept, including injection of local anaesthetics. Regarding this latter, different options have emerged recently such as the adductor canal block, performed before the surgery by the anaesthesiologist or the infiltration of the articulation performed by the surgeon at the of the intervention. No trial has compared these two approaches. As practice of medicine should be based on evidence, we decided to undertake this randomised controlled trial where we compared the adductor canal block with the local infiltration analgesia technique in terms of pain and functional outcomes
- Detailed Description
Patients scheduled to undergo anterior cruciate ligament reconstruction under general anaesthesia will be randomly allocated to two groups: local infiltration analgesia or adductor canal block.
The local infiltration analgesia will be performed by the surgeon at the end of surgery with 20 mLs of ropivacaine 0.5%. The adductor canal block will be performed by the anaesthesiologist under ultrasound guidance after the surgery, before awaking the patient, using the same solution (20 mLs ropivacaine 0.5%)
Postoperative analgesia will include intravenous patient-controlled analgesia of morphine (settings 1 mg/ml, 2 ml/10 minutes, 40 mg/4 hours), ibuprofen (3x400 mg) and acetaminophen (4x1000 mg).
A research assistant and a physiotherapist, both blinded to the group allocation, will collect pain and rehabilitation data, respectively.
Recruitment & Eligibility
- Status
- COMPLETED
- Sex
- All
- Target Recruitment
- 104
- patients from 18 to 50 years old scheduled to undergo anterior cruciate ligament reconstruction
- peripheral neuropathy
- pre-existing femoral neuropathy
- diabetes mellitus
- alcoholism
- drug addiction
- cancer with chemotherapy
- chronic pain state
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Arm && Interventions
Group Intervention Description Adductor canal block Ropivacaine 0.5% 20 mLs Injection of local anaesthetics under ultrasound guidance in the adductor canal by the anaesthesiologist after the surgery, before awaking the patient. Local infiltration analgesia Ropivacaine 0.5% 20 mLs Infiltration of the knee by the surgeon with local anaesthetics under general anaesthesia.
- Primary Outcome Measures
Name Time Method Total morphine consumption (mg) 24 h postoperatively
- Secondary Outcome Measures
Name Time Method Total morphine consumption (mg) 72 h postoperatively Pain scores (numeric rating scale, 0-10) at rest and on movement 72 h postoperatively Postoperative nausea and vomiting (yes/no) 72 h postoperatively Pruritus (yes/no) 72 h postoperatively Active flexion 72 h postoperatively Flexion of the knee by the patient measured in degrees
Distance walked (meters) 72 h postoperatively Quadriceps muscle strength (numeric scale, 1-5) 72 h postoperatively Anterior Cruciate Ligament - Return to Sport after Injury scale 4 months postoperatively Anterior cruciate ligament -Return to Sport after Injury scale 8 months postoperatively International Knee Documentation Committee score 8 months postoperatively
Trial Locations
- Locations (1)
Department of Anesthesia, Centre Hospitalier Universitaire Vaudois and University of Lausanne
🇨ðŸ‡Lausanne, Vaud, Switzerland