Total Knee Arthroplasty
Conditions
Keywords
Total Knee Arthroplasty, Intravenous Lidocaine Infusion, Femoral Block Catheter
Brief summary
Total knee replacement is often associated with severe postoperative pain, especially in the first 24 hours. Patient controlled analgesia (PCA) and continuous femoral block with PCA are commonly used to treat postoperative pain after total knee arthroplasty. However, PCAs use opioids. Opioids are excellent painkillers but their use is hampered by side effects such as nausea, vomiting, bowel dysfunction, urinary retention, pruritus, sedation and respiratory depression. We propose to test the hypothesis that adding a low dose lidocaine infusion to PCAs will lower the amount of opioids that these patients receive, thereby improving patient safety while still providing adequate analgesia. In addition, continuous femoral block has been shown to provide superior postoperative pain control when compared to morphine PCA. Therefore, postoperative pain levels of study subjects will be compared to those subjects who receive a combination of a continuous femoral block catheter with a PCA.
Interventions
PROCEDUREContinuous femoral catheter block
A constant infusion of ropivacaine 0.2% without epinephrine will be given to each subject via continuous femoral catheter in Group A.
DRUGLidocaine
Lidocaine 1.33mg/kg/hr continuous IV infusion following induction of general anesthesia to 24 hours postoperatively.
Preservative free normal saline 1.33mg/kg/hr continuous IV infusion following induction of general anesthesia to 24 hours postoperatively.
Sponsors
Loma Linda University
Study design
Allocation
RANDOMIZED
Intervention model
FACTORIAL
Primary purpose
TREATMENT
Masking
TRIPLE (Subject, Caregiver, Investigator)
Eligibility
Sex/Gender
ALL
Age
18 Years to 80 Years
Healthy volunteers
No
Inclusion criteria
1. Undergoing a total knee arthroplasty 2. Be American Society of Anesthesiologist physical status 1,2, or 3 3. Be willing and capable of providing informed consent 4. Be English speaking
Exclusion criteria
1. Age greater than 80 years old or younger than 18 years old 2. Congestive hear failure 3. Hepatic insufficiency 4. Neurological disorders 5. Psychiatric disorders 6. Steroid treatment 7. History of atrial fibrillation 8. Chronic pain disorder with opioid treatment
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Total PCA opioid consumption | 72 hours |
Secondary
| Measure | Time frame |
|---|---|
| Time to first flatus | 72 hours postoperatively |
Countries
United States
Outcome results
None listed