Adductor Canal Nerve Block Following Total Knee Arthroplasty

Overview

The purpose of this study is that an adductor canal nerve block (putting numbing medicine near the nerve) has been shown to produce excellent pain relief with less pain medication use after knee replacement surgery.The investigators will be comparing the amount of pain relief following knee replacement surgery when you have a nerve block in place. There will be approximately 66 subjects participating in this study. After surgery subjects will receive numbing medication every 6 hours for 48 hours. Subjects will also receive a morphine PCA (patient controlled analgesia) after surgery and pain medication by mouth every 4 hours around the clock with the option to receive more pain medication if needed. Subjects will participate in the study up to 3 days.

Full Title of Study: “Adductor Canal Nerve Block Following Total Knee Arthroplasty: A Randomized, Prospective Study Comparing High vs. Low Volume Bolus of 0.33% Ropivacaine”

Study Type

  • Study Type: Interventional
  • Study Design
    • Allocation: Randomized
    • Intervention Model: Single Group Assignment
    • Primary Purpose: Treatment
    • Masking: Single (Participant)
  • Study Primary Completion Date: July 25, 2017

Interventions

  • Drug: Morphine PCA started at the end of surgery, 1 Percocet 1/325mg every 4 hours; may receive a second Percocet if needed.
  • Drug: For the 30ml ropivacaine the intervention would be the subject can request extra pain medication which would be Percocet and/or morphine PCA.

Arms, Groups and Cohorts

  • Active Comparator: 15ml ropivacaine
    • Depending on what dose of ropivacaine the subject is randomized to he/she could receive the 15ml dose injected into the catheter every 6 hours
  • Active Comparator: 30ml ropivacaine
    • If the subject is randomized to 30ml ropivacaine he/she will be injected through the catheter every 6 hours.

Clinical Trial Outcome Measures

Primary Measures

  • Total Opiate pain medication
    • Time Frame: The total amount of opiate pain medication will be recorded at 6 hour intervals for 48 hours after surgery.
    • At the end of the 48 hours period the total opiate pain medication taken will be collected and used for comparison as our primary outcome

Secondary Measures

  • Patient satisfaction with pain control
    • Time Frame: We will look at the secondary outcome measure beginning every six hours for 48 hours after surgery
    • Secondary outcome measures will include demographic characteristics, pain scores, medication administration,patient satisfaction with pain control and any complications that may have arisen. We will also record the location of the adductor canal catheter on the final bolus dose.

Participating in This Clinical Trial

Inclusion Criteria

1. Is the subject undergoing primary unilateral total knee arthroplasty? 2. Is the subject 18 to 99 years of age? 3. Is the subject ASA class 1, 2, or 3? 4. Does the subject have a BMI less than 35? 5. Can the subject consent in the English language? Exclusion Criteria:

1. Does subject have an allergy to drugs used in this study; 2. Does subject have a daily intake of opiate medications that are considered stronger than hydrocodone? 3. Does subject have a history of alcohol or drug abuse 4. Has subject had a previous total knee arthroplasty? 5. Has subject had any neurologic deficits in the lower extremity being studied?

Gender Eligibility: All

Minimum Age: 18 Years

Maximum Age: 99 Years

Are Healthy Volunteers Accepted: No

Investigator Details

  • Lead Sponsor
    • Loma Linda University
  • Provider of Information About this Clinical Study
    • Sponsor

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