Intraoperative Direct vs Postoperative Ultrasound Guided Adductor Canal Nerve Block After Total Knee Arthroplasty
NCT ID: NCT03733509
Last Updated: 2022-10-26
Study Results
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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COMPLETED
NA
121 participants
INTERVENTIONAL
2018-11-12
2022-10-24
Brief Summary
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Detailed Description
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The most common postoperative nerve block alternative is the proximal femoral nerve block (FNB) which has shown improvements on postoperative pain measured by reduced opioid consumption and decreased pain at rest. Its main detractors argue that the motor nerve block effect is deleterious to early ambulation and have promoted adductor canal nerve blocks (ACB). Described by Lund et al in 2011, ACB block main femoral pain sensory contributors to the knee (articular branches of obturator nerve, vastus medialis branch and saphenous nerve) but is more distal to most motor branches to the quadriceps allowing near to normal quadriceps strength.
Standard ACB block is performed under ultrasound guidance after surgery completion, still in the operating room (OR). Recent literature has shown the anatomic feasibility of intraoperative ACB via blunt suprapatellar dissection in standard medial parapatellar TKA approaches. The study seeks to determine the effectiveness of standard ultrasound guidance ACB compared with intraoperative ACB.
Conditions
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Study Design
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RANDOMIZED
PARALLEL
TREATMENT
QUADRUPLE
Study Groups
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Intraoperative Block
Before skin closure, blunt suprapatellar dissection proximal to medial femoral condyle towards adductor canal. Nerve block at this level with 20ml of Bupivacaine 0.25%.
Postoperatively, mid-thigh ultrasound guided standard adductor canal nerve block with 20ml of saline solution (NaCl 0.9%).
Intraoperative Block
One shot adductor canal nerve block with 20ml of bupivacaine 0.25% through surgical incision
Ultrasound Placebo
One shot adductor canal nerve infusion with 20ml of saline solution mid-thigh
Ultrasound Block
Before skin closure, blunt suprapatellar dissection proximal to medial femoral condyle towards adductor canal. Nerve block at this level with 20ml of of saline solution (NaCl 0.9%).
Postoperatively, mid-thigh ultrasound guided standard adductor canal nerve block with 20ml Bupivacaine 0.25%.
Ultrasound Block
One shot adductor canal nerve block with 20ml of bupivacaine 0.25% mid-thigh
Intraoperative Placebo
One shot adductor canal nerve infusion with 20ml of saline solution through surgical incision
Interventions
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Intraoperative Block
One shot adductor canal nerve block with 20ml of bupivacaine 0.25% through surgical incision
Ultrasound Block
One shot adductor canal nerve block with 20ml of bupivacaine 0.25% mid-thigh
Intraoperative Placebo
One shot adductor canal nerve infusion with 20ml of saline solution through surgical incision
Ultrasound Placebo
One shot adductor canal nerve infusion with 20ml of saline solution mid-thigh
Eligibility Criteria
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Inclusion Criteria
* Unilateral
* American Society of Anesthesiologists (ASA) score I, II or III
* Accepts spinal anesthesia
Exclusion Criteria
* Chronic kidney disease
* Drug or alcohol abuse
* Chronic opioid use
* Allergic to bupivacaine or similar
50 Years
ALL
No
Sponsors
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Pontificia Universidad Catolica de Chile
OTHER
Responsible Party
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Principal Investigators
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Pablo Besa
Role: PRINCIPAL_INVESTIGATOR
Pontificia Universidad Catolica de Chile
Locations
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Pontificia Universidad Católica de Chile
Santiago, Santiago Metropolitan, Chile
Countries
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Other Identifiers
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180620002
Identifier Type: -
Identifier Source: org_study_id
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