Effect of LIA on Postoperative Pain Following ACL Reconstruction

NCT ID: NCT03873077

Last Updated: 2019-03-13

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

UNKNOWN

Clinical Phase

NA

Total Enrollment

40 participants

Study Classification

INTERVENTIONAL

Study Start Date

2019-03-01

Study Completion Date

2020-03-31

Brief Summary

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An anterior cruciate ligament (ACL) rupture is one of the most common sport injuries, which typically develops after a sudden knee torsion. Arthroscopic repair of the ACL is often required as a complete ACL tear can cause instability of the knee joint.

During arthroscopic reconstruction the lower leg is reattached to the upper leg using part of the hamstring tendon (mm. gracilis and mm. semitendinosus). Optimal postoperative analgesia is necessary to allow a quick recovery. Intravenous analgesia during surgery is often associated with a number of side effects such as nausea, vomiting and muscle weakness and does not anesthetize the donor site of the hamstring tendon graft. Local infiltration of ropivacaine and lidocaine in the knee joint and at the donor site can be a valuable asset to control the postoperative pain.

This study evaluates the effect of local infiltration analgesia (LIA) on the postoperative pain in the first month after an ACL reconstruction. Half of participants will only receive intravenous analgesia during surgery, the other half will receive intravenous analgesia and a LIA.

Detailed Description

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2 x 20 patients which are planned for arthroscopic ACL reconstruction are randomised: standard-group and LIA-group.

All patients receive standardised multimodal intravenous analgesia. After standardised induction of anesthesia, patient positioning and administration of basic analgetics (paracetamol, diclofenac, clonidine and morfine), patients in the LIA-group receive a local infiltration in the knee of 10 mL ropivacaine and 10 mL lidocaine.

Visual Analogue Scores are assessed 15 minutes after awakening from surgery and on Day 1, 2, 3, 7, 14, 21 and 28 after surgery. Postoperative analgesic consumption are registered in the first month after the surgery. The quality of recovery after anesthesia is assessed on Day 1 by the postoperative quality of recovery score (QoR-15).

Conditions

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Anterior Cruciate Ligament Rupture Pain, Postoperative

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Group A receives standard treatment (intravenous analgesia). Group B received intravenous analgesia and a LIA.
Primary Study Purpose

SUPPORTIVE_CARE

Blinding Strategy

TRIPLE

Participants Investigators Outcome Assessors

Study Groups

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intravenous analgesia

Patient receives intravenous analgesia: paracetamol 30 mg/kg, diclofenac 75 mg, clonidine 1 µg/kg and morfine 0,05 mg/kg

Group Type NO_INTERVENTION

No interventions assigned to this group

intravenous analgesia + LIA

Patient receives intravenous analgesia and a local infiltration analgesia in the knee

Group Type OTHER

local infiltration analgesia

Intervention Type PROCEDURE

10 mL ropivacaine 7.5 mg/mL and 10 mL lidocaine 10 mg/mL

Interventions

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local infiltration analgesia

10 mL ropivacaine 7.5 mg/mL and 10 mL lidocaine 10 mg/mL

Intervention Type PROCEDURE

Eligibility Criteria

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Inclusion Criteria

* elective arthroscopic anterior cruciate ligament reconstruction
* adult

Exclusion Criteria

* unwilling or unable to grant written informed consent
* revisions
* contra-indication for ropivacaine
Minimum Eligible Age

18 Years

Maximum Eligible Age

85 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Algemeen Ziekenhuis Maria Middelares

OTHER

Sponsor Role lead

Responsible Party

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Dr. Alain Kalmar, MD, PhD

Staff Anesthesist

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Alain F Kalmar

Role: PRINCIPAL_INVESTIGATOR

Maria Middelares Hospital

Locations

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General Hospital Maria Middelares

Ghent, Oost-Vlaanderen, Belgium

Site Status RECRUITING

Countries

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Belgium

Central Contacts

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Alain F Kalmar, MD, PhD, MSc

Role: CONTACT

+32 246 17 29

Pieter Byn, MD, Msc

Role: CONTACT

Facility Contacts

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Alain F Kalmar

Role: primary

References

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Stark PA, Myles PS, Burke JA. Development and psychometric evaluation of a postoperative quality of recovery score: the QoR-15. Anesthesiology. 2013 Jun;118(6):1332-40. doi: 10.1097/ALN.0b013e318289b84b.

Reference Type BACKGROUND
PMID: 23411725 (View on PubMed)

Lefevre N, Klouche S, de Pamphilis O, Herman S, Gerometta A, Bohu Y. Peri-articular local infiltration analgesia versus femoral nerve block for postoperative pain control following anterior cruciate ligament reconstruction: Prospective, comparative, non-inferiority study. Orthop Traumatol Surg Res. 2016 Nov;102(7):873-877. doi: 10.1016/j.otsr.2016.07.011. Epub 2016 Oct 4.

Reference Type BACKGROUND
PMID: 27720193 (View on PubMed)

Kerr DR, Kohan L. Local infiltration analgesia: a technique for the control of acute postoperative pain following knee and hip surgery: a case study of 325 patients. Acta Orthop. 2008 Apr;79(2):174-83. doi: 10.1080/17453670710014950.

Reference Type BACKGROUND
PMID: 18484242 (View on PubMed)

Kristensen PK, Pfeiffer-Jensen M, Storm JO, Thillemann TM. Local infiltration analgesia is comparable to femoral nerve block after anterior cruciate ligament reconstruction with hamstring tendon graft: a randomised controlled trial. Knee Surg Sports Traumatol Arthrosc. 2014 Feb;22(2):317-23. doi: 10.1007/s00167-013-2399-x. Epub 2013 Jan 23.

Reference Type BACKGROUND
PMID: 23338666 (View on PubMed)

Other Identifiers

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MMS.2019.001

Identifier Type: -

Identifier Source: org_study_id

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