Comparison of Regional Anesthesia Techniques After Total Knee Arthroplasty
- Conditions
- Postoperative PainKnee ArthropathyPain, AcuteMobility Limitation
- Interventions
- Procedure: continuous anesthesia of adductor canalProcedure: continuous anesthesia of femoral nerveProcedure: Spinal anesthesia
- Registration Number
- NCT03143738
- Lead Sponsor
- Medical University of Lublin
- Brief Summary
Comparison of continuous adductor canal block to continuous femoral nerve block in patients after total knee arthroplasty.
All patients will be anesthetized with spinal anesthesia. Continuous infusion of ropivacaine with a catheter implemented to the adductor canal or next to the femoral nerve.
The observed goals: pain intensity, the beginning and quality of rehabilitation.
- Detailed Description
Written consent will be obtained a day before the surgery. Only subarachnoidally anaesthetised patients may participate in the study. Pencil-point spinal needle and bupivacaine (Marcaine Heavy Spinal 0.5 %) will be used.
Before the beginning of operation, under ultrasound control, a catheter will be implemented to one of the chosen position: the adductor canal (the middle or lower third of thigh) or near the femoral nerve (below the inguinal ligament). The local anesthetic solution of 0.2 % ropivacaine will be started with an elastomeric pump (5 mL per hour, up to 72 hours) as soon as a catheter in the right position.
The pain will be measured with VAS (visual-analogue scale) 8, 24 and 48 hours after the end of operation, and at the discharge. At the same time, i.e.: 8, 24 and 48 hours from the end of surgery, the range of flexion and extension in the operated knee will be assessed. Moreover, the possibility of patient's sitting, standing up and walking will be noted.
All parameters will be reassessed before patients' discharge from the hospital. Each patient will receive paracetamol (1.0) and metamizol (1.0) intravenously (i.v.) q6h. 5 mg of morphine may be given as required, up to 2 dosages per day as a rescue medication.
Recruitment & Eligibility
- Status
- COMPLETED
- Sex
- All
- Target Recruitment
- 100
- knee arthroplasty
- obtained consent
- subarachnoid anaesthesia
- coagulopathy
- allergy to to local anesthetics
- depression, antidepressant drugs treatment
- epilepsy
- usage of painkiller before surgery
- addiction to alcohol or recreational drugs
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Arm && Interventions
Group Intervention Description continuous anesthesia of femoral nerve Spinal anesthesia - continuous anesthesia of adductor canal Spinal anesthesia - continuous anesthesia of adductor canal continuous anesthesia of adductor canal - continuous anesthesia of femoral nerve continuous anesthesia of femoral nerve -
- Primary Outcome Measures
Name Time Method Morphine consumption 24 hours from the end of surgery Total consumption of intravenous morphine by patients with the use of patient-controlled analgesia pump
- Secondary Outcome Measures
Name Time Method Knee flexion 8, 24, 48 hours from the end of surgery, and at the patient discharge from the hospital (an average 4-6 days) range of flexion in operated knee
Walking 8, 24, 48 hours from the end of surgery, and at the patient discharge from the hospital (an average 4-6 days) Possibility of walking by patients at scheduled time points
The change of acute postoperative pain 8, 24, 48 hours from the end of surgery, and at the patient discharge from the hospital (an average 4-6 days) Measured with VAS (visual-analogue scale)
Sitting 8, 24, 48 hours from the end of surgery, and at the patient discharge from the hospital (an average 4-6 days) Possibility of walking by patients at scheduled time points
Trial Locations
- Locations (1)
Michał Borys
🇵🇱Lublin, Poland