Pre vs. Postoperative Adductor Canal Block for Total Knee Arthroplasty: Prospective Randomized Trial
Overview
- Phase
- Phase 4
- Intervention
- Dexamethasone
- Conditions
- Knee Osteoarthritis
- Sponsor
- University of Miami
- Enrollment
- 84
- Locations
- 1
- Primary Endpoint
- Pain Status as Measured by Numeric Pain Scale
- Status
- Completed
- Last Updated
- last year
Overview
Brief Summary
The purpose of this project is to determine if a change in patient reported pain, nausea and vomiting after total knee arthroplasty can be observed with the substitution of a post operative adductor canal block for a preoperative adductor canal block in the current established peri-operative pain protocol and if these changes lead to a decrease in opioid consumption (in morphine equivalents).
Investigators
Victor Hugo Hernandez
Professor of Clinical
University of Miami
Eligibility Criteria
Inclusion Criteria
- •1- Patients 18 or older 2 - Patients undergoing primary total knee replacement at the University of Miami Hospital 3 - Patients that have capacity to provide medical consent
Exclusion Criteria
- •All patients under the age of 18
- •Prisoners, uncontrolled diabetics, increased risk of bleeding, pregnant women, women planning on becoming pregnant in the next year, and women who think they might be pregnant.
- •Patients with prior surgery or history of infection on the joint of interest.
- •Patients on steroid preoperatively.
- •Inability to provide medical consent.
- •Patients with a history of significant unmitigated pain in parts of their body not including the knee the procedure is to be performed or a history of pain catastrophizing (the tendency to magnify the threat value of the pain stimulus and to feel helpless in the context of pain, and by a relative inability to inhibit pain-related thoughts in anticipation of, during or following a painful event) regarding pain anywhere in the body.
- •Any condition that, in the opinion of the investigator, would compromise the well-being of the patient or the study or prevent the patient from meeting or performing study requirements will exclude the participant.
- •Allergy to local anesthetic or any medication used in the standard protocol for joint replacement.
Arms & Interventions
Preoperative Adductor Canal Block Group
Participants in this group will receive the standard of care treatment for pain management for TKA including a preoperative adductor canal block. Participants will be in this group for up to 24 hours after surgery.
Intervention: Dexamethasone
Preoperative Adductor Canal Block Group
Participants in this group will receive the standard of care treatment for pain management for TKA including a preoperative adductor canal block. Participants will be in this group for up to 24 hours after surgery.
Intervention: Acetaminophen
Preoperative Adductor Canal Block Group
Participants in this group will receive the standard of care treatment for pain management for TKA including a preoperative adductor canal block. Participants will be in this group for up to 24 hours after surgery.
Intervention: Lyrica
Preoperative Adductor Canal Block Group
Participants in this group will receive the standard of care treatment for pain management for TKA including a preoperative adductor canal block. Participants will be in this group for up to 24 hours after surgery.
Intervention: Celebrex
Preoperative Adductor Canal Block Group
Participants in this group will receive the standard of care treatment for pain management for TKA including a preoperative adductor canal block. Participants will be in this group for up to 24 hours after surgery.
Intervention: Meloxicam
Preoperative Adductor Canal Block Group
Participants in this group will receive the standard of care treatment for pain management for TKA including a preoperative adductor canal block. Participants will be in this group for up to 24 hours after surgery.
Intervention: Oxycodone
Preoperative Adductor Canal Block Group
Participants in this group will receive the standard of care treatment for pain management for TKA including a preoperative adductor canal block. Participants will be in this group for up to 24 hours after surgery.
Intervention: Ropivacaine
Postoperative Adductor Canal Block Group
Participants in this group will receive the standard of care treatment for pain management after TKA, however, the adductor canal block will be placed postoperatively. Participants will be in this group for up to 24 hours
Intervention: Dexamethasone
Postoperative Adductor Canal Block Group
Participants in this group will receive the standard of care treatment for pain management after TKA, however, the adductor canal block will be placed postoperatively. Participants will be in this group for up to 24 hours
Intervention: Acetaminophen
Postoperative Adductor Canal Block Group
Participants in this group will receive the standard of care treatment for pain management after TKA, however, the adductor canal block will be placed postoperatively. Participants will be in this group for up to 24 hours
Intervention: Lyrica
Postoperative Adductor Canal Block Group
Participants in this group will receive the standard of care treatment for pain management after TKA, however, the adductor canal block will be placed postoperatively. Participants will be in this group for up to 24 hours
Intervention: Celebrex
Postoperative Adductor Canal Block Group
Participants in this group will receive the standard of care treatment for pain management after TKA, however, the adductor canal block will be placed postoperatively. Participants will be in this group for up to 24 hours
Intervention: Meloxicam
Postoperative Adductor Canal Block Group
Participants in this group will receive the standard of care treatment for pain management after TKA, however, the adductor canal block will be placed postoperatively. Participants will be in this group for up to 24 hours
Intervention: Oxycodone
Postoperative Adductor Canal Block Group
Participants in this group will receive the standard of care treatment for pain management after TKA, however, the adductor canal block will be placed postoperatively. Participants will be in this group for up to 24 hours
Intervention: Ropivacaine
Outcomes
Primary Outcomes
Pain Status as Measured by Numeric Pain Scale
Time Frame: 24 hours postoperatively
Scale with numeric scores ranging from 0 (least) to 10 (most) pain
Secondary Outcomes
- Episodes of Nausea(24 hours postoperatively)
- Episodes of Vomiting(24 hours postoperatively)
- Discharges by Midnight on POD1(Up to 48 hours postoperatively)
- Patients Reporting Nausea(24 hours postoperatively)
- Hours Hospitalized(Up to 336 hours postoperatively)
- Discharges by Midnight POD0(Up to 24 hours postoperatively)
- Patients Reporting Vomiting(24 hours postoperatively)
- Total Opioid Consumption(24 hours postoperatively)
- Nights Hospitalized(Up to 14 nights postoperatively)