Analgesia After Total Knee Replacement Surgery

NCT ID: NCT01489631

Last Updated: 2015-06-08

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

81 participants

Study Classification

INTERVENTIONAL

Study Start Date

2013-03-31

Study Completion Date

2014-04-30

Brief Summary

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Postoperative pain after total knee replacement surgery is difficult to treat. Mobilisation and hospital discharge might be delayed. Recent research shows that intra-articular infiltration with local anesthetics and perioperative prescription of gabapentin can improve outcome.

Objective of the study: Comparison of mobilisation speed and postoperative NRS-scores of patients after total knee replacement surgery which is treated with epidural analgesia or peroperative infiltration of the knee. Appraisal of the value of gabapentin for reduction of postoperative opiate consumption.

Detailed Description

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Study design:

Prospective randomised study

Study population:

Patients aged eighteen years or older, in whom knee replacement surgery is indicated. They will have spinal anaesthesia and epidural analgesia if indicated by randomisation. They must not have contraindications for epidural analgesia or the used medication in this study.

Intervention:

The first group will be treated with epidural analgesia. Before surgery the epidural catheter will be placed according to local guidelines. After the operation epidural infiltration with bupivacaine and sufentanil will be commenced. The second group will receive local infiltration with ropivacaine of the knee during surgery. Half of these patients will additionally be treated with gabapentin.

Primary study parameters/outcome of the study:

NRS-score (11-scale Numeric Rating Scale in which 0 means no pain, and 10 means most pain imaginable) in rest.

Secondary study parameters/outcome of the study:

Speed of mobilisation, postoperative opiate consumption. NRS scores during flexion exercise of the knee and during walking exercise.

Conditions

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Total Knee Arthroplasty

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

SUPPORTIVE_CARE

Blinding Strategy

NONE

Study Groups

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epidural analgesia

The first group will be treated with epidural analgesia. Before surgery the epidural catheter will be placed according to local guidelines. After the operation epidural infiltration with bupivacaine and sufentanil will be commenced.

Group Type ACTIVE_COMPARATOR

marcaine

Intervention Type DRUG

bupivacaine 0,125%

sufentanil

Intervention Type DRUG

sufentanil 1mcg/ml

local infiltration

The second group will receive local infiltration with ropivacaine of the knee during surgery.

Group Type ACTIVE_COMPARATOR

naropin

Intervention Type DRUG

ropivacaine 0,2%, 3x 50 ml during surgery

local infiltration and gabapentin

The third group will receive local infiltration with ropivacaine of the knee during surgery and will additionally be treated with gabapentin.

Group Type ACTIVE_COMPARATOR

naropin

Intervention Type DRUG

ropivacaine 0,2%, 3x 50 ml during surgery

neurontin

Intervention Type DRUG

gabapentin 600 mg pre-operative 3 dd 300 mg

Interventions

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naropin

ropivacaine 0,2%, 3x 50 ml during surgery

Intervention Type DRUG

marcaine

bupivacaine 0,125%

Intervention Type DRUG

sufentanil

sufentanil 1mcg/ml

Intervention Type DRUG

neurontin

gabapentin 600 mg pre-operative 3 dd 300 mg

Intervention Type DRUG

Other Intervention Names

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ropivacaine bupivacaine sufenta forte gabapentin

Eligibility Criteria

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Inclusion Criteria

* 18 years or older and legally responsible
* Waiting for total knee replacement surgery
* Informed consent

Exclusion Criteria

* Contraindications for epidural analgesia
* Aortic Valve stenosis
* Severely compromised cardiac function
* infection near epidural punction site
* Redo knee surgery
* Previous arthrotomies
* Allergy/Hypersensitivity for study mediation or all other used medication
* Participation in other studies
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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St. Antonius Hospital

OTHER

Sponsor Role lead

Responsible Party

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Leon Timmerman

anesthesiologist

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Leon Timmerman, MD

Role: PRINCIPAL_INVESTIGATOR

Anesthesiologist

Louis N Marting, MD

Role: PRINCIPAL_INVESTIGATOR

Orthopedic surgeon

Locations

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St. Antonius Hospital

Nieuwegein, , Netherlands

Site Status

Countries

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Netherlands

Other Identifiers

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TKP-37796

Identifier Type: -

Identifier Source: org_study_id

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