Single-injection Adductor Canal Block for Total Knee Arthroplasty Under Spinal Anesthesia

Overview

This study evaluates the effect of the single-injection adductor canal block in patients receiving total knee arthroplasty under spinal anesthesia.

Full Title of Study: “The Effect of Postoperative Single-injection Adductor Canal Block for Multimodal Pain Control in Patients Receiving Total Knee Arthroplasty Under Spinal Anesthesia”

Study Type

  • Study Type: Interventional
  • Study Design
    • Allocation: Randomized
    • Intervention Model: Parallel Assignment
    • Primary Purpose: Treatment
    • Masking: Triple (Participant, Care Provider, Investigator)
  • Study Primary Completion Date: August 29, 2020

Detailed Description

This study aims to evaluate the effect of the single-injection adductor canal block in patients receiving total knee arthroplasty under spinal anesthesia. The effect of the single-injection adductor canal and continuous adductor canal block in patients receiving total knee arthroplasty under general anesthesia has been well established. However, due to the residual effect of spinal anesthesia, the effect of the single-injection adductor canal block needs to be determined. The investigators hypothesize that the single-injection adductor canal block will decrease the total sum of 2h, 6h, 12h, and 24h pain score.

Interventions

  • Procedure: adductor canal block
    • After the end of the surgery, at the arrival of PACU, the patient’s leg is prepared and draped in a sterile manner. Assisted by the high-frequency linear ultrasound transducer, we target the mid-thigh level and the 22-gauge/8cm needle is introduced in plain through the sartorius muscle. the correct position for the tip of the needle in the adductor canal is checked and a bolus injection of 0.5% ropivacaine 15ml is given.
  • Procedure: control group
    • After the end of the surgery, at the arrival of PACU, the patient’s leg is prepared and draped in a sterile manner. Assisted by the high-frequency linear ultrasound transducer, we target the mid-thigh level and the 22-gauge/8cm needle is introduced in plain through the sartorius muscle. the correct position for the tip of the needle in the adductor canal is checked and a bolus injection of normal saline15ml is given.

Arms, Groups and Cohorts

  • Sham Comparator: control group
    • normal saline injection
  • Experimental: test group
    • 0.5% ropivacaine injection

Clinical Trial Outcome Measures

Primary Measures

  • the sum of pain score
    • Time Frame: 2 hours, 6 hours, 12 hours, and 24 hours after intervention
    • VAS pain score (0 to 10) is measured using numeric pain rating scale at 2 hours, 6 hours, 12 hours, and 24 hours 0: no pain, 10: worst pain

Secondary Measures

  • Postoperative nausea and vomiting
    • Time Frame: 2 hours, 6 hours, 12 hours, and 24 hours after intervention
    • degree of postoperative nausea and vomiting (0 to 3) 0: no nausea, no vomiting, 1: nausea present, but no vomiting, 2: nausea present, vomiting once, 3: vomiting repeatedly within 30 minutes.
  • Postoperative opioid consumption
    • Time Frame: 2 hours, 6 hours, 12 hours, and 24 hours intervention
    • amount of postoperative opioid consumption based on oral morphine equivalent daily dose

Participating in This Clinical Trial

Inclusion Criteria

  • adult patients receiving total-knee arthroplasty under spinal anesthesia
  • ASA class 1-3

Exclusion Criteria

  • infection at the needle injection site
  • hard for pain evaluation
  • CRPS patient with lower extremity symptom
  • chronic opioid user
  • those with side effect to local anesthetics
  • those getting revision total-knee arthroplasty or with the previous operation at the same knee area
  • those getting the surgery under general anesthesia due to the failed spinal anesthesia

Gender Eligibility: All

Minimum Age: 19 Years

Maximum Age: 80 Years

Are Healthy Volunteers Accepted: Accepts Healthy Volunteers

Investigator Details

  • Lead Sponsor
    • Seoul National University Hospital
  • Provider of Information About this Clinical Study
    • Principal Investigator: Jin-Tae Kim, professor – Seoul National University Hospital

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