Systemic Lidocaine Versus Ultrasound-guided Adductor Canal Block for Patients Undergoing Total Knee Arthroplasty
- Conditions
- Arthroplasty, Replacement, KneeTotal Knee Arthroplasty
- Interventions
- Drug: Saline IV
- Registration Number
- NCT04828083
- Lead Sponsor
- Rhode Island Hospital
- Brief Summary
The investigators are evaluating the postoperative outcomes in patients undergoing total knee arthroplasty that receive either systemic lidocaine or ultrasound-guided adductor canal block as part of their anesthetic plan.
- Detailed Description
Patients scheduled to have total knee arthroplasty will typically receive a single shot adductor canal block to serve as the primary anesthetic and as part of a multi-modal post-operative analgesic plan. The use of adductor canal block is still limited to where trained anesthesiologists in regional anesthesia are available. There are other nonopioid analgesic adjuncts, such as Lidocaine, which is is widely available and is a very commonly used local anesthetic. A major advantage of lidocaine is that it is not associated with a significant side effect profile. Intravenous lidocaine which can be administered during surgery and/or after surgery has demonstrated anti-inflammatory effects and can significantly decrease the reliance on opioid use for adequate pain management in abdominal and spine surgeries. The addition of systemic lidocaine infusion as part of a multimodal analgesia strategy to minimize opioid related side effects might prove to be a useful combination for clinicians where adductor canal blocks are not a viable option. However, the level of evidence comparing the efficacy of intravenous lidocaine versus adductor canal block to reduce postoperative opioid consumption in patients undergoing TKA is limited. We hypothesized that there will be no meaningful clinical difference between systemic lidocaine and ultrasound-guided adductor canal block in the 24-hour postoperative analgesia period.
Recruitment & Eligibility
- Status
- RECRUITING
- Sex
- All
- Target Recruitment
- 120
- ASA PS 1-3 patients undergoing primary, unilateral total knee arthroplasty
- ASA PS classification of 4 or greater
- Pre-existing neuropathy
- Coagulopathy
- Chronic opioid consumption (>3 months)
- Infection at the site
- Known allergy to study medications (lidocaine)
- High grade atrioventricular block (cardiac conduction system impairment)
- A history of CVA/TIA
- Currently using lidocaine patches
- Known liver disease
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Arm && Interventions
Group Intervention Description Ultrasound-guided adductor canal block with local anesthetic Saline IV Single shot Ultrasound-guided adductor canal block with 0.5% ropivacaine 30 ml Ultrasound-guided adductor canal block with saline Lidocaine IV Single shot Ultrasound-guided adductor canal block with 30 mL of normal saline (Sodium chloride)
- Primary Outcome Measures
Name Time Method Postoperative opioid consumption 24 hours Postoperative opioid consumption will be converted to equivalent dose of oral morphine.
- Secondary Outcome Measures
Name Time Method Pain Scores up to 2 hours (post anesthesia recovery unit), 6 hours, 12 hours, and 24 hours after surgery. Patients were asked to rate their pain score during activity on a 11-point scale (0 = no pain to 10 = excruciating pain).
Quality of Recovery 24 hours The QoR-15 questionnaire has 15 questions that assess patient-reported quality of a patient's postoperative recovery using a 11-point numerical rating scale that leads to a minimum score of 0 (poor recovery) and a maximum score of 150 (excellent recovery).
Trial Locations
- Locations (1)
Rhode Island Hospital
🇺🇸Providence, Rhode Island, United States