Knee Arthroscopy for Pain Control

Not Applicable

Not yet recruiting

• Conditions: Knee Arthroscopy

• Registration Number: NCT06701175
• Lead Sponsor: University of Alabama at Birmingham

Brief Summary

This study aims to determine the effectiveness of an anterolateral genicular nerve block and portal anesthesia in controlling pain in the perioperative period after knee arthroscopy. Opioid consumption, the use of non-opioid medications, complication rate, and sleep quality will also be measured.

Detailed Description

Orthopaedic surgeries are some of the most painful operations to recover from, especially when involving cruciate ligaments. Because of this, orthopaedic surgeons have worked to optimize postoperative pain management that provides the best relief. Opioids traditionally were the primary medication for pain control during the perioperative period, however, with the current opioid epidemic and opioids being the leading cause of accidental deaths in the United States, physicians have transitioned to multimodal pain control which has shown to provide better pain control. In cases involving knee arthroscopy, pain management options include variations of nerve blocks, medications, surgical techniques, and postoperative activity.

An anterolateral genicular nerve block has been proposed that focuses on decreasing postoperative pain in the lateral aspect of the knee by targeting the lateral retinacular nerve, the nerve to the vastus lateralis, and the articular branch of the nerve to the vastus intermedius. Adductor canal blocks and intraarticular injections are known methods of providing postoperative pain control, but due to their risks, they may be inappropriate for knee arthroscopy. An anterolateral geniculate nerve block targets sensory, terminal nerve fibers outside the joint capsule, theoretically avoiding the risks of large nerve irritation and chondrotoxicity. Postoperative portal injections are another form of analgesia provided after knee arthroscopy and have been demonstrated to be equally effective in controlling pain as intraarticular injections one hour postoperatively. Otherwise, portal injections in knee arthroscopy have not been extensively studied in the literature.

Patients will be sent home after surgery with a survey to be completed at 2, 4, 6, 12, 24, and 48 hours and 1 week. The survey will inquire about the period from the prior survey to the current survey and will evaluate pain via Visual Analog Score, opioid consumption, non-opioid medication use, sleep, and intervention complications. Patients will be called at 12 and 48 hours and 1 week as reminders to complete the survey.

Study Timeline

• Status Verified: 2024-11
• Study First Submitted: 2024-11-11
• Study First Submitted QC: 2024-11-20
• Last Update Submitted: 2024-11-20
• Study First Posted: 2024-11-22
• Last Update Posted: 2024-11-22
• Study Start: 2025-12
• Primary Completion: 2026-08
• Study Completion: 2026-10

Recruitment & Eligibility

• Status: NOT_YET_RECRUITING
• Sex: All
• Target Recruitment: 72

Inclusion Criteria

• skeletally mature patients with indications for knee arthroscopy

Exclusion Criteria

• include patients with previous knee surgery on the operative side
• opioid use within six weeks before surgery that is deemed to be chronic or excessive
• gabapentin use within six weeks before surgery
• diagnosis of chronic pain, fibromyalgia, or other somatosensory disorder(s)
• history of radicular pain or neuropathy in the operative limb
• patients with cancer

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: SINGLE_GROUP

Primary Outcome Measures

Name	Time	Method
Postoperative Pain Management	2, 4, 6, 12, 24, and 48 hours and 1 week post-op	Collected variables will include average and worst pain (0-10 scale, higher values representing increased pain), dose frequency of prescribed opioid analgesics, consumption of prescribed nonopioid analgesics, the longest period of uninterrupted sleep (in hours; only obtained at 12 and 24 hours and 1 week), and the subjective quality of sleep (0-10 scale, higher values representing better sleep), and overall satisfaction with pain control (five-point Likert scale, higher values representing increased satisfaction). A Visual Analog Score will be used in the evaluation of pain.