Comparing Adductor Canal Block and Adductor Canal Block-Local Infiltration Analgesia for Post-operative Pain Management
- Conditions
- ACL TearACLACL Injury
- Interventions
- Procedure: Local Infiltration AnestheticProcedure: Local Infiltration Anesthetic + Adductor Canal Block
- Registration Number
- NCT04721119
- Lead Sponsor
- Ottawa Hospital Research Institute
- Brief Summary
Anterior cruciate ligament (ACL) reconstruction is one of the most commonly performed surgeries amongst young orthopedic surgery patients. Optimal post-operative pain control helps to reduce the opioid burden and to improve the patient's experience. Regional anesthesia, such as the femoral nerve block (FNB) and adductor canal block (ACB), are commonly used for post-operative pain control after surgery. The ACB has replaced the FNB. This is because the ACB targets the femoral nerve, while avoiding the numbing effects on quadricep muscle strength that make it difficult to move the leg. Another form of pain control is local infiltration anesthesia (LIA), which directly blocks pain in the knee. Similar to the ACB, it avoids the numbing effects on the quadricep muscle.This can help improve patient safety and experience by reducing risks of falls and allowing the patient to move earlier. This can also be associated with decreased time in the hospital and decreased costs. Technically, it is less complex and can be done the shorter period of time.
The purpose of this study is to refine the pain management technique following anterior cruciate ligament surgery. More specifically, the aim of this study is to evaluate the effects of LIA alone, and a LIA-ACB combination on post-operative pain and thigh muscle strength.
- Detailed Description
Not available
Recruitment & Eligibility
- Status
- UNKNOWN
- Sex
- All
- Target Recruitment
- 100
- English speaking or any other language with possibility of adequate translation
- ASA I-III patients
- Age 18-50
- BMI ≤ 38 kg/m2
- Refusal or inability to provide informed consent
- Any contraindication to regional anesthesia including coagulopathy or bleeding diathesis,
- Allergy to local anesthetics, or infection at the site of the block
- History of long-term opioid intake (more than 3 months use) or chronic pain disorder (more than 3 months)
- History of preexisting neuropathy in the operative leg
- Revision of ACL repair
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Arm && Interventions
Group Intervention Description Local Infiltration Anesthetic Local Infiltration Anesthetic This group of patients will receive the local infiltration anesthetic only. Local Infiltration Anesthetic + Adductor Canal Block Local Infiltration Anesthetic + Adductor Canal Block This group of patients will receive the local infiltration anesthetic and adductor canal block combination.
- Primary Outcome Measures
Name Time Method Oral morphine equivalent consumption Up to 24-hours after surgery Cumulative oral morphine equivalent consumption over 24 hours post-op
Quadriceps motor strength Pre-op, 30 minutes post-anesthesia Percent decrease in quadriceps motor strength at 30 minutes following anesthesia compared to baseline
- Secondary Outcome Measures
Name Time Method Quality of Recovery At 24 hours post-operative Measured using the QoR-15 questionnaire at 24 hours post-op
inta-operative opioid consumption during surgery Cumulative amount of opioids consumed during surgery
Time in hospital From hospital admission to hospital discharge (approximately 12 hours) Time from admission to discharge
Nerve Block Complications up to 24 hours post-operative, up to 2 weeks post-operative Presence or absence of nerve block complications
Post-operative Pain Up to 24 hours post-operative area under the curve for rest pain scores during the first 24 hours post-op, using the numeric pain rating scale from 0-10, with 0 being no pain and 10 being the worst possible pain
Oral morphine equivalent consumption in PACU PACU admission to PACU discharge (approximately 4 hours) Cumulative oral morphine equivalent consumed in PACU