Addition of Popliteal Plexus Block to Continuous Femoral Nerve Block for Total Knee Arthroplasty
Overview
- Phase
- Not Applicable
- Intervention
- Ropivacaine 0.5% Injectable Solution
- Conditions
- Pain, Postoperative
- Sponsor
- University Hospital, Geneva
- Enrollment
- 66
- Locations
- 1
- Primary Endpoint
- Total iv morphine consumption (mg)
- Last Updated
- 6 years ago
Overview
Brief Summary
The popliteal plexus block has been described as an alternative analgesic postoperative pain treatment for total knee arthroplasty. It consists of injecting local anaeshetics inside the distal end of the adductor canal close to the adductor hiatus, adjacent to the femoral artery, between the medial vastus muscle and the adductor magnus muscle, in order to anesthetize the popliteal plexus. However, the analgesic efficacy has never been demonstrated in a randomized controlled trial. Therefore the objective of this study is to investigate the analgesic benefit of this block combined with a continuous femoral nerve block, on patients scheduled for total knee athroplasty.
Detailed Description
Patients scheduled to undergo total knee arthroplasty under general anesthesia will be randomly allocated to two groups: continuous femoral nerve block alone or continuous femoral nerve block with addition of a popliteal plexus block. The continuous femoral nerve block will be performed by the anesthesiologist with 15 mLs of ropivacaine 0.5%, under ultrasound guidance before the beginning of the general anesthesia. The popliteal plexus block will be done by the anesthesiology, under ultrasound guidance, before the beginning of the surgery, under general anesthesia. Postoperative analgesia will include acetaminophen (4 x 1000 mg), ibuprofen (3 x 400 mg) and a continuous infusion of Ropivacaine 0.2%.
Investigators
Kevin Stebler
Principal Investigator
University Hospital, Geneva
Eligibility Criteria
Inclusion Criteria
- •Patients scheduled for total knee athroplasty under general anesthesia
Exclusion Criteria
- •Kidney disease with GFR \< 50 ml/mn
- •Daily opioid consumption \> 1 month
- •Allergy to local anesthetics
- •Neurological problems of the lower extremity
- •other contraindications to peripheral nerve blocks
Arms & Interventions
Popliteal plexus block and continuous femoral nerve block
Intervention: Ropivacaine 0.5% Injectable Solution
continuous femoral nerve block
Intervention: Ropivacaine 0.5% Injectable Solution
Outcomes
Primary Outcomes
Total iv morphine consumption (mg)
Time Frame: 12 postoperative hours
Secondary Outcomes
- Average and maximum pain scores (Numeric rating scale 0-10)(12, 24 and 48 postoperative hours)
- Popliteal plexus block duration of action (hours)(up to 48 postoperative hours)
- Knee pain localization (anterior, internal, posterior, lateral, medial)(2, 12, 24 and 48 postoperative hours)
- Popliteal plexus block procedure time (minutes)(When performing the popliteal plexus block)
- Total iv morphine consumption (mg)(24 and 48 postoperative hours)
- Plantarflexion and dorsiflexion ankle strength (Newtons)(2 and 24 postoperative hours)
- Sciatic extension of popliteal plexus block(2 and 24 postoperative hours)