Total Knee Arthroplasty
Conditions
Brief summary
Aim of this study is to evaluate the effects of the adductor canal block on the early and medium term ( 1 month) rehabilitation compared to the continuous femoral block commonly used in the knee prosthesis.
Interventions
PROCEDUREAdductor canal
Perinervous catheter (stimulong sono- Pajunk, Germany) will be insert in adductor canal through tuohy needle (18G, 100mm length) under ultrasound guidance.
PROCEDUREFemoral
Perinervous catheter (stimulong sono- Pajunk, Germany) will be insert between femoral nerve and femoral artery through tuohy needle (18G, 100mm length) under ultrasound guidance.
PROCEDURESpinal Anesthesia
Spinal anesthesia will be perform at L3-L4 or L4-L5 level. Levobupivacaine 0,5% 12mg will be injected.
PROCEDURELocal anesthetic infusion
Continuous infusion of levobupivacaine 0,125% at 8ml/h rate through perinervous catheter until 5th postoperative day.
PROCEDUREIntravenous analgesia
Ketorolac 30mg 3 times/day and morphine Patients Control Analgesia (1mg/h, max 4mg/h) administered.
DRUGLevobupivacaine 0,125%
DRUGKetorolac 30mg
DRUGMorphine
DEVICEstimulong sono, Pajunk, Germany
Sponsors
ASST Gaetano Pini-CTO
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
SINGLE (Subject)
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* patients undergoing total knee arthroplasty
Exclusion criteria
* diabetes * neurological disorders * coagulation disorders * rheumatoid arthritis * chronic opioids therapy * allergy to local anesthetic
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Up and Go test | 5th postoperative day | Knee functional evaluation at 5th postoperative day. up and go test: time need to get up from a chair, walk for 3 meters, and come back to seat down on the chair |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| VAS score | up to POD5 | Evaluation of VAS static and VAS dynamic during hospital stay |
| Morphine request | up to POD5 | Opioids consumption will be recorded throughout postoperative period |
| Range of motion | 5th postoperative day | Physiotherapist measures the maximum active/passive range of motion |
| Falling risk | 5th postoperative day | Evaluation of falling risk with Berg Balance Scale |
| Quadriceps strength | 5th postoperative day | evaluate muscle strength with an isometric force dynamometer to measure the force produced during a maximum voluntary isometric contraction in a lying position by the knee flex to 90°. |
Countries
Italy
Outcome results
None listed