Pre vs Post Block in Total Knee Arthroplasty (TKA)

NCT ID: NCT05974501

Last Updated: 2025-02-12

Study Results

Results available

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Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

PHASE4

Total Enrollment

84 participants

Study Classification

INTERVENTIONAL

Study Start Date

2023-09-29

Study Completion Date

2024-01-22

Brief Summary

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The purpose of this project is to determine if a change in patient reported pain, nausea and vomiting after total knee arthroplasty can be observed with the substitution of a post operative adductor canal block for a preoperative adductor canal block in the current established peri-operative pain protocol and if these changes lead to a decrease in opioid consumption (in morphine equivalents).

Detailed Description

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Conditions

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Knee Osteoarthritis Arthroplasty Complications Postoperative Pain

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

SUPPORTIVE_CARE

Blinding Strategy

TRIPLE

Participants Investigators Outcome Assessors

Study Groups

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Preoperative Adductor Canal Block Group

Participants in this group will receive the standard of care treatment for pain management for TKA including a preoperative adductor canal block. Participants will be in this group for up to 24 hours after surgery.

Group Type ACTIVE_COMPARATOR

Dexamethasone

Intervention Type DRUG

Dexamethasone 10mg administered via IV once postoperatively within 24 hours for pain and swelling

Acetaminophen

Intervention Type DRUG

1,000mg administered via tablet every 8 hours for pain during the first 1-2 weeks postoperatively

Lyrica

Intervention Type DRUG

Administered via tablet 75mg nightly for pain during the first 1-2 weeks postoperatively

Celebrex

Intervention Type DRUG

200mg administered via tablet twice a day for pain and swelling during the first 1-2 weeks postoperatively

Meloxicam

Intervention Type DRUG

30mg administered via IV once postoperatively within 24 hours for pain and swelling

Oxycodone

Intervention Type DRUG

5mg administered via tablet every 4 hours as needed for pain during the first 1-2 weeks postoperatively

Ropivacaine

Intervention Type DRUG

20 milliliters Ropivacaine 0.2% administered via injection perioperatively.

Postoperative Adductor Canal Block Group

Participants in this group will receive the standard of care treatment for pain management after TKA, however, the adductor canal block will be placed postoperatively. Participants will be in this group for up to 24 hours

Group Type EXPERIMENTAL

Dexamethasone

Intervention Type DRUG

Dexamethasone 10mg administered via IV once postoperatively within 24 hours for pain and swelling

Acetaminophen

Intervention Type DRUG

1,000mg administered via tablet every 8 hours for pain during the first 1-2 weeks postoperatively

Lyrica

Intervention Type DRUG

Administered via tablet 75mg nightly for pain during the first 1-2 weeks postoperatively

Celebrex

Intervention Type DRUG

200mg administered via tablet twice a day for pain and swelling during the first 1-2 weeks postoperatively

Meloxicam

Intervention Type DRUG

30mg administered via IV once postoperatively within 24 hours for pain and swelling

Oxycodone

Intervention Type DRUG

5mg administered via tablet every 4 hours as needed for pain during the first 1-2 weeks postoperatively

Ropivacaine

Intervention Type DRUG

20 milliliters Ropivacaine 0.2% administered via injection perioperatively.

Interventions

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Dexamethasone

Dexamethasone 10mg administered via IV once postoperatively within 24 hours for pain and swelling

Intervention Type DRUG

Acetaminophen

1,000mg administered via tablet every 8 hours for pain during the first 1-2 weeks postoperatively

Intervention Type DRUG

Lyrica

Administered via tablet 75mg nightly for pain during the first 1-2 weeks postoperatively

Intervention Type DRUG

Celebrex

200mg administered via tablet twice a day for pain and swelling during the first 1-2 weeks postoperatively

Intervention Type DRUG

Meloxicam

30mg administered via IV once postoperatively within 24 hours for pain and swelling

Intervention Type DRUG

Oxycodone

5mg administered via tablet every 4 hours as needed for pain during the first 1-2 weeks postoperatively

Intervention Type DRUG

Ropivacaine

20 milliliters Ropivacaine 0.2% administered via injection perioperatively.

Intervention Type DRUG

Other Intervention Names

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Adductor Canal Block

Eligibility Criteria

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Inclusion Criteria

1- Patients 18 or older 2 - Patients undergoing primary total knee replacement at the University of Miami Hospital 3 - Patients that have capacity to provide medical consent

Exclusion Criteria

1. All patients under the age of 18
2. Prisoners, uncontrolled diabetics, increased risk of bleeding, pregnant women, women planning on becoming pregnant in the next year, and women who think they might be pregnant.
3. Patients with prior surgery or history of infection on the joint of interest.
4. Patients on steroid preoperatively.
5. Inability to provide medical consent.
6. Patients with a history of significant unmitigated pain in parts of their body not including the knee the procedure is to be performed or a history of pain catastrophizing (the tendency to magnify the threat value of the pain stimulus and to feel helpless in the context of pain, and by a relative inability to inhibit pain-related thoughts in anticipation of, during or following a painful event) regarding pain anywhere in the body.
7. Any condition that, in the opinion of the investigator, would compromise the well-being of the patient or the study or prevent the patient from meeting or performing study requirements will exclude the participant.
8. Allergy to local anesthetic or any medication used in the standard protocol for joint replacement.
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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University of Miami

OTHER

Sponsor Role lead

Responsible Party

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Victor Hugo Hernandez

Professor of Clinical

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Victor H. Hernandez, MD

Role: PRINCIPAL_INVESTIGATOR

University of Miami

Locations

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University of Miami

Miami, Florida, 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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20230147

Identifier Type: -

Identifier Source: org_study_id

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