Postoperative Pain Control After Periarticular Injection During Total Knee Arthroplasty

NCT ID: NCT02570503

Last Updated: 2022-03-04

Study Results

Results available

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Basic Information

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Recruitment Status

TERMINATED

Clinical Phase

PHASE4

Total Enrollment

64 participants

Study Classification

INTERVENTIONAL

Study Start Date

2015-10-31

Study Completion Date

2021-02-11

Brief Summary

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This study will evaluate the use of a local injection around the knee (periarticular) during total knee replacement (TKR) surgery to see if it reduces postoperative pain levels. The injection is a combination of various medications which are thought to reduce pain levels.

Approximately 128 patients will participate in this study, half of the patients will receive this injection during surgery and the other half will receive a saline (salt water) injection. Pain scores after the surgery will be compared between the two groups.

All patients will also receive a long-acting (24 hours) morphine injection during surgery.

The hypothesis is that those participants receiving intrathecal Duramorph and local periarticular injections will have improved pain scores and reduced narcotic use when compared with intrathecal Duramorph alone at 48 hours postoperatively.

Detailed Description

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Data Collection:

Data will be collected from the patient's medical record after discharge

Variables include:

* Age
* Sex
* BMI
* UPAT score (Universal Pain Assessment Tool)- this is assessed hourly postoperatively by nursing staff on Orthopedics Unit
* Patient's assessment of acceptability of pain
* UPAT score as assessed by physical therapy pre and post therapy sessions
* Duramorph dose
* Time patient arrived on the Orthopedic Unit
* Length of ambulation during physical therapy sessions
* Amount of supplementary opioids (measured in morphine equivalents)
* Use of anti-emetics
* Any complications of surgery including venous thromboembolic event, cardiac event, bleeding event
* Length of hospital stay

The pharmacist will randomize patients to either study arm, prepare the injection and maintain dispensing records.

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

QUADRUPLE

Participants Caregivers Investigators Outcome Assessors

Study Groups

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ROP/KET/CLON/EPI/SAL

Ropivacaine (ROP) (5mg/ml)- 50ml Ketorolac (KET) (30mg/ml)- 1ml Clonidine (CLON) (0.1mg/ml)- 0.8ml Epinephrine (EPI) (1mg/ml)- 0.5ml 0.9% sodium chloride SAL)--47.7 ml

Group Type EXPERIMENTAL

Ropivacaine

Intervention Type DRUG

Ropivacaine (5mg/ml)-50ml

Ketorolac

Intervention Type DRUG

ketorolac (30mg/ml)- 1 ml

Clonidine

Intervention Type DRUG

clonidine (0.1mg/ml)- 0.8ml

Epinephrine

Intervention Type DRUG

epinephrine (1mg/ml)-1ml

0.9% sodium chloride

Intervention Type DRUG

Sodium chloride 0.9%- 47.7 ml

Placebo

0.9% Sodium Chloride- 100ml

Group Type PLACEBO_COMPARATOR

0.9% sodium chloride

Intervention Type DRUG

Sodium chloride 0.9%- 47.7 ml

Interventions

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Ropivacaine

Ropivacaine (5mg/ml)-50ml

Intervention Type DRUG

Ketorolac

ketorolac (30mg/ml)- 1 ml

Intervention Type DRUG

Clonidine

clonidine (0.1mg/ml)- 0.8ml

Intervention Type DRUG

Epinephrine

epinephrine (1mg/ml)-1ml

Intervention Type DRUG

0.9% sodium chloride

Sodium chloride 0.9%- 47.7 ml

Intervention Type DRUG

Other Intervention Names

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periarticular injection periarticular injection periarticular injection periarticular injection periarticular injection

Eligibility Criteria

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Inclusion Criteria

* Age 18 or older
* Written informed consent

Exclusion Criteria

* Pregnant women
* Creatinine clearance less than 60 ml/min
* BMI greater than 40
* Currently use greater than 80mg morphine-equivalents daily (pre-operatively)
* Receive a unicondylar knee replacement
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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Virginia Commonwealth University

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Gregory Golladay, MD

Role: PRINCIPAL_INVESTIGATOR

Virginia Commonwealth University

Locations

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Virginia Commonwealth University

Richmond, Virginia, United States

Site Status

Countries

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United States

Provided Documents

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Document Type: Study Protocol and Statistical Analysis Plan

View Document

Other Identifiers

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HM20004125

Identifier Type: -

Identifier Source: org_study_id

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