The Impact of Single-shot Adductor Canal Block Versus Continuous Femoral Nerve Block on Rehabilitation After Total Knee Replacement

NCT ID: NCT05487053

Last Updated: 2025-03-27

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

RECRUITING

Clinical Phase

NA

Total Enrollment

220 participants

Study Classification

INTERVENTIONAL

Study Start Date

2024-02-03

Study Completion Date

2028-07-01

Brief Summary

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Total knee replacement (TKR) is considered the most effective and safe method of radical treatment of late stages of knee osteoarthritis. A well-known problem of TKR is a severe postoperative pain syndrome, which is observed in more than 50% of patients.

Femoral nerve block (FNB) is the "gold standard" for continuous postoperative analgesia after total knee replacement, as it is effective in reducing the frequency of use of opioid analgetics and reduce the duration of hospitalization. At the same time, the negative effect of this method is the motor blockade of the quadriceps femoris muscle which leads to functional impairment and is associated with an increased risk of falling.

Adductor canal block (ACB) provides adequate analgesia comparable to femoral nerve block. Moreover, ACB doesn't affect the motor function of the quadriceps femoris muscle.

The possibility of enhanced recovery after total knee replacement is the reason to compare single-shot adductor canal block and continuous femoral nerve block.

Detailed Description

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Conditions

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Osteo Arthritis Knee Gonarthrosis

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

TRIPLE

Participants Investigators Outcome Assessors

Study Groups

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Single-shot adductor canal block

Group Type EXPERIMENTAL

Single-shot adductor canal block

Intervention Type PROCEDURE

Postoperative analgesia in this group will be carried out by a single-shot bolus of 20 ml Ropivacaine 0.5% in the region of the middle third of the adductor canal.

Continuous femoral nerve block

Group Type ACTIVE_COMPARATOR

Continuous femoral nerve block

Intervention Type PROCEDURE

Postoperative analgesia in this group will be carried out by continuous infusion of local anesthetics through a catheter installed to the femoral nerve in the area of the femoral triangle. Ropivacaine 0.2% solution will be used for postoperative analgesia. Local anesthetic infusion rate is 4 ml/h to 10 ml/h.

Interventions

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Single-shot adductor canal block

Postoperative analgesia in this group will be carried out by a single-shot bolus of 20 ml Ropivacaine 0.5% in the region of the middle third of the adductor canal.

Intervention Type PROCEDURE

Continuous femoral nerve block

Postoperative analgesia in this group will be carried out by continuous infusion of local anesthetics through a catheter installed to the femoral nerve in the area of the femoral triangle. Ropivacaine 0.2% solution will be used for postoperative analgesia. Local anesthetic infusion rate is 4 ml/h to 10 ml/h.

Intervention Type PROCEDURE

Eligibility Criteria

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Inclusion Criteria

* Age ≥ 18
* Planned primary total knee replacement
* Planned neuraxial anesthesia
* Written informed consent

Exclusion Criteria

* Urgent surgery
* Planned revision total knee replacement
* Known allergic reaction to anesthetics
* Confirmed localized infection at the puncture sites
* Confirmed localized tumor at the puncture sites
* Peripheral neuropathy of the lower extremities
* Parkinson's disease
* Previously enrolled in this trial
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Negovsky Reanimatology Research Institute

OTHER_GOV

Sponsor Role lead

Responsible Party

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Valery Likhvantsev, MD

Head of the Research V. Negovsky Reanimatology Research Institute

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Valery Likhvantsev

Role: PRINCIPAL_INVESTIGATOR

Negovsky Reanimatology Research Institute

Locations

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Clinical Hospital on Yauza

Moscow, , Russia

Site Status RECRUITING

Countries

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Russia

Central Contacts

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Valery Likhvantsev

Role: CONTACT

+79036235982

Levan Berikashvili

Role: CONTACT

+79263308968

Facility Contacts

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Levan Berikashvili, PhD

Role: primary

+79263308968

Other Identifiers

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AdORe - ACB

Identifier Type: -

Identifier Source: org_study_id

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