Comparison of Continuous Femoral Nerve Block and Adductor Canal Block After Total Knee Replacement Therapy

Not Applicable

Completed

• Conditions: Total Knee Arthroplasty; Total Knee Replacement; Adductor Canal Block; Femoral Nerve Block
• Interventions: Drug: Ropivacaine

• Registration Number: NCT02125903
• Lead Sponsor: Philipps University Marburg Medical Center

Brief Summary

The blockade of the femoral nerve (FNB) is the most common postoperative pain therapy after total knee replacement. Because of motor-driven weakness of the quadriceps muscle induced by femoral nerve block mobilization of Patients is difficult even dangerous (falls) and hospital stays are extended.

An alternative method could be an adductor canal block (ACB). Anatomical studies of the adductor canal demonstrated that the adductor canal contains the saphenous nerve, a pure sensory nerve for medial and anterior aspects of the knee and the tibia without any motor function.

This prospective, double-blinded, randomized study investigates the effect of FNB and ACB on quadriceps motor weakness and analgesia determined by Numeric Rating Scale (NRS).

We expect the ACB to be superior in muscle strength but equal in pain score. Both groups receive an additional anterior sciatic nerve block for complete sensory block of the operated knee

Detailed Description

Not available

Study Timeline

• Study Start: 2013-05
• Study First Submitted: 2014-02-05
• Study First Submitted QC: 2014-04-28
• Study First Posted: 2014-04-29
• Primary Completion: 2014-05
• Study Completion: 2014-11
• Status Verified: 2015-01
• Last Update Submitted: 2015-01-23
• Last Update Posted: 2015-01-26

Recruitment & Eligibility

• Status: COMPLETED
• Sex: All
• Target Recruitment: 44

Inclusion Criteria

• patients with knee replacement therapy and general anaesthesia
• informed consent
• preoperative "timed up and go" test performable

Exclusion Criteria

• emergency patients
• BMI > 40 kg/m2
• American Society of Anaesthesiologists physical status (ASA) 4-5
• severe chronic obstructive pulmonary disease (COPD)
• rheumatic arthritis, diabetic Polyneuropathy, M. Parkinson
• nerve injury of lumbosacral plexus
• coagulopathy with bleeding tendency
• not capable of speaking or understanding german or english

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Arm && Interventions

Group	Intervention	Description
Continuous Adductor Canal Block (CACB)	Ropivacaine	Continuous Adductor Canal block performed with: loading dose 0,375% Ropivacaine 15ml (56,25mg) start infusion 0,2% Ropivacaine 6ml/h Procedure: Femoral Nerve Block. Adductor Canal Block Drug: Ropivacaine
Continuous Femoral Nerve Block (CFNB)	Ropivacaine	Continuous Femoral Nerve Block performed with: loading dose 0,375% Ropivacaine 15ml (56,25mg) start infusion 0,2% Ropivacaine 6ml/h Procedure: Femoral Nerve Block. Adductor Canal Block Drug: Ropivacaine

Primary Outcome Measures

Name	Time	Method
Timed-Up and Go-test for mobility evaluation	third postoperative day	The patient is observed and timed while he rises from an arm chair, walks 3 meters, turns, walks back, and sits down again.

Secondary Outcome Measures

Name	Time	Method
Quadriceps strength	6, 24, 28, 72 hours postoperative	Numeric Scale (0-5)
Pain Scores	6, 24, 48, 72 hours postoperative	Numeric Rating Scale (NRS), 0-10 for Rest / Stress. in Addition total Body NRS Pain
Ropivacaine consumption (each catheter)	24, 48, 72 hours postoperative	Measurement of the total amount
Mobility Score (MoSc)	24,48,72 hours postoperative	Is calculated with routine data. Measurement for overall mobilization (none- passive mobilization, sitting, standing, walking with walking device, walkin free or with crutches)
Analgesic regimen	preop and 0, 6 , 24, 48, 48 hours postoperative	Documentation of analgesic prescriptions and rescue medications during postoperative course
CAS (Cumulated Ambulation Score)	24,48,72 hours postoperative	Cumulated Ambulation Score is calculated with routine data. Measurement for ambulation ability

Trial Locations

Locations (1)

University of Marburg Department of Anaesthesia And Intensive Care Medicine; 🇩🇪 Marburg, Germany