Pain, Postoperative
Conditions
Keywords
femoral block, fascia iliaca block, ACL repair, post-operative analgesia, knee surgery, ACL damage, knee damage
Brief summary
The study aims to compare standard techniques used to control pain after knee surgery. The investigators hypothesize that the fascia iliaca block is faster, safer and as good as or better than the femoral block, with or without a stimulating catheter.
Detailed description
60 patients being treated for ACL repair or knee arthroplasties under regional anesthesia will be randomized to three groups: Fascia Iliaca Block (FIB), Femoral Block (FB) with stimulating catheter or FB without stimulating catheter. A catheter will be placed according to each technique, before the surgery. A bolus of local anesthetic will be given pre-surgery and at the end of the operation, in all groups. A continuous infusion will be started for 48 hours. All patients receive a standard analgesia cocktail and rescue medication. Pain and level of activity, as well as side effects, will be evaluated.
Interventions
PROCEDUREFascia Iliaca Block
PROCEDUREFemoral Block (with stimulating catheter)
PROCEDUREFemoral Block (without stimulating catheter)
Sponsors
McGill University Health Centre/Research Institute of the McGill University Health Centre
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
DOUBLE
Eligibility
Sex/Gender
ALL
Age
18 Years to 80 Years
Healthy volunteers
No
Inclusion criteria
* Patients coming for ACL or knee prosthesis surgery * Between 18-80 years old * Consenting for spinal anesthesia
Exclusion criteria
* Major neurologic diseases * Obesity with body mass index (BMI) \> 30 * Infection at the punction sites (back and/or groin) * Diabetes mellitus for longer than 5 years * Coagulopathy
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| pain relief; measured by WOMAC | before surgery and at days 7, 60, 90 |
| pain relief; evaluated from standard datasheet | over 48-hour period |
| pain relief; measured by VAS at rest and on activity | before surgery, before discharge from PACU and on evenings of days 1, 2, 7, 60, 90 |
Secondary
| Measure | Time frame |
|---|---|
| thigh circumference 20 cm above the knee | measured before surgery and at days 7, 60, 90 |
| neurological exam of femorocutaneous, femoral and obturator nerves | evaluated once spinal anesthesia has worn off, post-surgery, before anesthesia |
| level of activity; measured using questionnaire | at 7-10 days and at 2 and 3 months |
| need for rescue analgesia | in recovery room and at home |
| need for second bolus or crossing over between groups | — |
| knee range of bending | measured before surgery, and at days 7, 60, 90 |
Countries
Canada
Contacts
Primary ContactJuan F Asenjo, MD
Outcome results
None listed