Postoperative Pain in Total Knee Arthroplasty: a Comparison Between General and Spinal Anesthesia
Overview
- Phase
- Phase 4
- Intervention
- Spinal Block
- Conditions
- Total Knee Replacement Surgery
- Sponsor
- Meir Medical Center
- Enrollment
- 60
- Primary Endpoint
- postoperative pain measured by Visual Analogue Scale
- Last Updated
- 8 years ago
Overview
Brief Summary
Total knee arthroplasty may be conducted either under general anesthesia or spinal block. previous studies have shown that spinal block leads to less complications. The investigators aim to find whether post-operative pain is also diminished under spinal block compared to general anesthesia
Detailed Description
Patients who will be registered for a total knee replacement in Meir Medical Center and that will agree to participate in the study will be enrolled into one of two groups: the first, which will be the default choice for all patients, will be operated under a spinal block. Patients who will ask specifically for general anesthesia, or those in which the anesthesiologist will prefer general anesthesia due to medical reasons will be enrolled into the second group. For both groups the surgeon will add intraoperative peri-articular infiltration of local Marcaine injections, which was previously shown to diminish postoperative pain. The postoperative pain will be evaluated with the Visual Analogue Scale at different point during the first 48 hours following operation. Physiotherapy achievements will also be recorded. The investigators will try to find whether one of the two groups suffered less pain or had achieved better results in physical therapy.
Investigators
David segal
Principle Investigator
Meir Medical Center
Eligibility Criteria
Inclusion Criteria
- •all patient who will undergo total knee arthroplasty
Exclusion Criteria
- •patients who will not agree to participate in the study
- •patients who will die during the research timeframe
Arms & Interventions
Spinal block
Intrathecal 10 mg Heavy Marcaine, 200 mcg Morphine + High volume local anesthesia infiltration Bupivacaine 5mg/ml + adrenaline 5 mcg/ml 3mg/kg ideal body weight diluted with 100cc Normal Saline + Total Knee Replacement ( which will not be the intervention of interest)
Intervention: Spinal Block
Spinal block
Intrathecal 10 mg Heavy Marcaine, 200 mcg Morphine + High volume local anesthesia infiltration Bupivacaine 5mg/ml + adrenaline 5 mcg/ml 3mg/kg ideal body weight diluted with 100cc Normal Saline + Total Knee Replacement ( which will not be the intervention of interest)
Intervention: Total knee replacement
General anesthesia
1-3 mg IV propofol 0.5 mg/kg IV Rocuronium + Fentanyl 2-3 mcg/kg + Morphine 0.1mg/kg IV Maintenance: Volatile anesthetic + High volume local anesthesia infiltration Bupivacaine 5mg/ml + adrenaline 5 mcg/ml 3mg/kg ideal body weight diluted with 100cc Normal Saline + Total Knee Replacement ( which will not be the intervention of interest)
Intervention: General anesthetic
General anesthesia
1-3 mg IV propofol 0.5 mg/kg IV Rocuronium + Fentanyl 2-3 mcg/kg + Morphine 0.1mg/kg IV Maintenance: Volatile anesthetic + High volume local anesthesia infiltration Bupivacaine 5mg/ml + adrenaline 5 mcg/ml 3mg/kg ideal body weight diluted with 100cc Normal Saline + Total Knee Replacement ( which will not be the intervention of interest)
Intervention: Total knee replacement
Outcomes
Primary Outcomes
postoperative pain measured by Visual Analogue Scale
Time Frame: 48 hours
Visual Analogue Scale scores of pain will be documented at different timed during the first 48 postoperative hours
Secondary Outcomes
- Achievements in physical therapy measured by walking distance on the first postoperative day(24 hours)