Continuous Saphenous Nerve Block for Total Knee Arthroplasty

Overview

Our study will compare the use of continuous saphenous nerve block performed at the adductor canal in addition to Local Infiltration Analgesia (LIA) versus a Sham block in addition to LIA for total knee replacement. The investigators hypothesize that the saphenous nerve block performed at the level of the adductor canal in addition to LIA provides better pain relief than the LIA alone without significantly compromising muscle strength and physiotherapy, enabling patients to mobilize early with reduced opioid consumption and les side effects. The investigators will enroll a total of 40 patients (20 patients will receive continuous saphenous nerve block in addition to LIA and 20 will receive the sham block and LIA). Until discharge, the investigators will record patients' pain scores, opioid consumption, side effects and physical therapy progress. If our study proves that the continuous saphenous nerve block in addition to LIA can effectively reduce postoperative pain scores to an acceptable level with better physical therapy progress and less opioid consumption, it could be seen as a more attractive alternative to LIA alone or other traditionally used methods of postoperative pain control that compromises muscle strength and physiotherapy.

Full Title of Study: “Continuous Saphenous Nerve Block (Adductor Channel) and Local Infiltration Analgesia (LIA) for Total Knee Arthroplasty”

Study Type

  • Study Type: Interventional
  • Study Design
    • Allocation: Randomized
    • Intervention Model: Parallel Assignment
    • Primary Purpose: Treatment
    • Masking: Quadruple (Participant, Care Provider, Investigator, Outcomes Assessor)
  • Study Primary Completion Date: January 2012

Interventions

  • Procedure: continuous saphenous nerve block
    • Postoperative intermittent boluses of 15 Ml Ropivacaine 7,5 mg/Ml every 12 hours for three days
  • Procedure: Saline boluses in nerve catheter
    • A nerve catheter will be placed in the adductor canal using saline instead of Ropivacaine for intermittent boluses.

Arms, Groups and Cohorts

  • Sham Comparator: Saline boluses in nerve catheter
    • A nerve catheter will be placed in the adductor canal using saline instead of Ropivacaine for intermittent boluses.
  • Active Comparator: Continuous saphenous nerve block
    • Postoperative intermittent boluses of 15 Ml Ropivacaine 7,5 mg/Ml every 12 hours for three days

Clinical Trial Outcome Measures

Primary Measures

  • Pain scores
    • Time Frame: 3 days postoperative
    • VAS pain scores

Secondary Measures

  • Opioid consumption
    • Time Frame: 3 days postoperative
  • physical therapy progress
    • Time Frame: 3 days postoperative

Participating in This Clinical Trial

Inclusion Criteria

  • ASA I-III – Age: 40-75 – Unilateral TKA – Use of Spinal anesthesia Exclusion Criteria:

  • Allergy to any of the study medications – Intolerance to morphine – Contraindication to a spinal anesthetic – Intraoperative use of any volatile anesthetic – Chronic opioid use – ASA Class 4-5 – Rheumatoid arthritis or Diabetes mellitus with neuropathy – Liver or kidney failure – BMI above 40 – Severe COPD

Gender Eligibility: All

Minimum Age: 40 Years

Maximum Age: 75 Years

Are Healthy Volunteers Accepted: No

Investigator Details

  • Lead Sponsor
    • Henning Lykke Andersen
  • Provider of Information About this Clinical Study
    • Sponsor-Investigator: Henning Lykke Andersen, Consultant – Frederiksberg University Hospital
  • Overall Official(s)
    • Henning L. Andersen, M.D., Principal Investigator, Frederiksberg Hospital
    • Dusanka Zaric, M.D., Ph.d., Study Director, Frederiksberg Hospital.

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