Knee osteoarthritis requiring total knee arthroplasty total knee arthroplasty, postoperative pain
Conditions
Interventions
Both groups: Femoral triangle block (0.25% levobupivacaine 20mL) + iPACK block (0.25% levobupivacaine 20mL).
Intervention group additionally receives caudal epidural morphine (normal saline 10mL + mo
caudal epidural morphine, femoral triangle block, iPACK block
Sponsors
Nakazawa Keisuke
Eligibility
Sex/Gender
All
Inclusion criteria
Inclusion criteria: 1. Adults aged 18 years or older 2. ASA-PS classification 3 or less 3. Patients undergoing primary total knee arthroplasty 4. Written informed consent obtained
Exclusion criteria
Exclusion criteria: 1. Allergy to amide-type local anesthetics 2. Allergy to morphine or other opioids 3. Patients on anticoagulation therapy with PT-INR greater than 1.2 or dual antiplatelet therapy 4. Moderate to severe hepatic dysfunction (Child-Pugh class B or higher) 5. Moderate to severe renal dysfunction (eGFR less than 30 mL/min/1.73m2) 6. Diagnosed or suspected sleep apnea syndrome 7. Chronic opioid users (continuous use for more than 3 months) 8. Pregnant or breastfeeding women
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Numerical Rating Scale (NRS) score (0-10 scale) during knee flexion on postoperative day 1 morning (6-8 AM) | — |
Secondary
| Measure | Time frame |
|---|---|
| NRS during movement at each time point (extubation, 2h, 6h, 12h, 21:00 before sleep, 24h), NRS at rest at each time point, proportion of patients experiencing NRS 4 or greater during movement within 24 hours, total IV-PCA consumption in 24 hours, incidence of opioid-related side effects (nausea/vomiting, pruritus, respiratory depression) | — |
Contacts
Public ContactKeisuke Nakazawa
Nihon University Itabashi Hospital
Outcome results
None listed