Total Knee Arthroplasty Utilizing Adductor Canal Block: Effect on Quadriceps Sparing

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

TERMINATED

Clinical Phase

NA

Total Enrollment

33 participants

Study Classification

INTERVENTIONAL

Study Start Date

2014-02-28

Study Completion Date

2015-12-31

Brief Summary

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The purpose of this study is to investigate whether there is quantitative motor-sparing of the quadriceps muscles following adductor canal nerve block versus femoral nerve block. Patients will be randomly placed into one of three treatment groups: 1) Femoral nerve block, 2) Adductor canal nerve block - low volume, or 3) Adductor canal nerve block - high volume. Quadriceps function will be assessed in the operating room using a skin patch and electrical stimulation. Follow up visits with the patients will continue over the course of 2 days during patient's stay at the hospital. A total of 60 patients will be enrolled for the study.

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Detailed Description

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Conditions

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Osteoarthritis (Knee)

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

DOUBLE

Participants Outcome Assessors

Study Groups

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High volume Adductor canal block

Adductor canal block performed in the distal thigh (1/3 of the total distance between the superior border of the patella and the femoral crease, cephalad to the patella) utilizing an injectate volume of 30 mL 0.25% bupivacaine/ epinephrine

Group Type EXPERIMENTAL

High Volume Adductor Canal Block

Intervention Type PROCEDURE

Adductor canal block performed in the distal thigh (1/3 of the total distance between the superior border of the patella and the femoral crease, cephalad to the patella) utilizing an injectate volume of 30 mL 0.25% bupivacaine/ epinephrine

Low volume Adductor Canal Block

Adductor canal block performed in the distal thigh (1/3 of the total distance between the superior border of the patella and the femoral crease, cephalad to the patella) utilizing an injectate volume of of 10 mL 0.75% bupivacaine/ epinephrine

Group Type EXPERIMENTAL

Low Volume Adductor Canal Block

Intervention Type PROCEDURE

Adductor canal block performed in the distal thigh (1/3 of the total distance between the superior border of the patella and the femoral crease, cephalad to the patella) utilizing an injectate volume of of 10 mL 0.75% bupivacaine/ epinephrine

Femoral nerve block

Femoral nerve block with 10 mL 0.75 % bupivacaine/epinephrine

Group Type EXPERIMENTAL

Femoral Nerve Block

Intervention Type PROCEDURE

Femoral nerve block with 10 mL 0.75 % bupivacaine/epinephrine

Interventions

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High Volume Adductor Canal Block

Adductor canal block performed in the distal thigh (1/3 of the total distance between the superior border of the patella and the femoral crease, cephalad to the patella) utilizing an injectate volume of 30 mL 0.25% bupivacaine/ epinephrine

Intervention Type PROCEDURE

Low Volume Adductor Canal Block

Adductor canal block performed in the distal thigh (1/3 of the total distance between the superior border of the patella and the femoral crease, cephalad to the patella) utilizing an injectate volume of of 10 mL 0.75% bupivacaine/ epinephrine

Intervention Type PROCEDURE

Femoral Nerve Block

Femoral nerve block with 10 mL 0.75 % bupivacaine/epinephrine

Intervention Type PROCEDURE

Eligibility Criteria

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Inclusion Criteria

* All patients undergoing primary unilateral total knee arthroplasty
* Planned use of combined spinal epidural (CSE) anesthesia
* Ability to follow study protocol

Exclusion Criteria

* Contraindication to a spinal or epidural anesthetic
* Chronic opioid use (defined as daily or almost daily use of opioids for \>3 months)
* Allergy to local anesthetics
* Pre-existing neuropathy or weakness of the operative limb
* Any neuromuscular disorder
* Diabetes type I and II
* Contraindication to a femoral nerve block or adductor canal nerve block
* Allergy or intolerance to any of the study medications
* BMI \> 35 kg/m2

Minimum Eligible Age

18 Years

Maximum Eligible Age

80 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No