Ultrasound-guided Continuous Proximal Adductor Canal vs Continuous Femoral Nerve Block for Postoperative Pain Control and Rehabilitation Following Total Knee Arthroplasty

Overview

The purpose of the study is to compare continuous femoral nerve block with continuous proximal adductor canal block for postoperative pain control and rehabilitation.

Full Title of Study: “Ultrasound-guided Continuous Proximal Adductor Canal Versus Continuous Femoral Nerve Block for Postoperative Pain Control and Rehabilitation Following Total Knee Arthroplasty”

Study Type

  • Study Type: Interventional
  • Study Design
    • Allocation: Randomized
    • Intervention Model: Parallel Assignment
    • Primary Purpose: Treatment
    • Masking: Single (Outcomes Assessor)
  • Study Primary Completion Date: November 2016

Detailed Description

Patients meeting the criteria: American Society of Anesthesiologists (ASA) class I and II, that are scheduled for elective total knee arthroplasty, will be recruited into the study. Subjects will be randomized into 2 groups: those who will receive a continuous proximal adductor canal block (ACB) and those who will receive a continuous femoral nerve block (FNB).

Interventions

  • Procedure: Continuous proximal adductor canal block
    • Subjects will be randomized into 2 groups: those who will receive a continuous proximal adductor canal block (ACB) and those who will receive a continuous femoral nerve block (FNB).
  • Procedure: Continuous femoral nerve block
    • Subjects will be randomized into 2 groups: those who will receive a continuous proximal adductor canal block (ACB) and those who will receive a continuous femoral nerve block (FNB).

Arms, Groups and Cohorts

  • Active Comparator: adductor canal block (ACB)
    • Subjects randomized to this groups receive a continuous proximal adductor canal block (ACB) during surgery.
  • Active Comparator: femoral nerve block (FNB)
    • Subjects randomized to this groups receive a continuous femoral nerve block (FNB) during surgery.

Clinical Trial Outcome Measures

Primary Measures

  • Motor effects
    • Time Frame: 24 hours (postoperatively)
    • Subjects’ change in motor effects will be assessed as maximum voluntary isometric contraction (MVIC) in the quadriceps muscle.

Secondary Measures

  • Pain score
    • Time Frame: On average between 6 and 8 hours postoperatively
    • Subjects’ pain will be assessed using a numerical pain score, where 10 is the greatest amount of pain.
  • Pain score
    • Time Frame: 24 hours (postoperatively)
    • Subjects’ pain will be assessed using a numerical pain score, where 10 is the greatest amount of pain.
  • Opioid consumption
    • Time Frame: On average between 6 and 8 hours postoperatively
    • Subjects’ pain will be assessed by tracking opioid consumption postoperatively.
  • Opioid consumption
    • Time Frame: 24 hours (postoperatively)
    • Subjects’ pain will be assessed by tracking opioid consumption postoperatively.
  • Motor effects
    • Time Frame: On average between 6 and 8 hours postoperatively
    • Subjects’ change in motor effects will be assessed as maximum voluntary isometric contraction (MVIC) in the quadriceps muscle.

Participating in This Clinical Trial

Inclusion Criteria

  • Patients with an American Society of Anesthesiologists Physical Status Classification System (ASA) score of 1 or 2 that are healthy without systemic disease or have mild systemic disease, respectively. – The patient will need to be able to have decision-making capacity and ability to consent for the study. Exclusion Criteria:

  • Patients with an American Society of Anesthesiologists Physical Status Classification System (ASA) score greater than 2. – Patients unable to have decision-making capacity and ability to consent for the study.

Gender Eligibility: All

Minimum Age: 18 Years

Maximum Age: N/A

Are Healthy Volunteers Accepted: Accepts Healthy Volunteers

Investigator Details

  • Lead Sponsor
    • Yale University
  • Provider of Information About this Clinical Study
    • Sponsor
  • Overall Official(s)
    • Richa Wardham, MD, Principal Investigator, Yale School of Medicine

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