Knee Osteoarthritis
Conditions
Keywords
Ambulatory home regional, adductor canal block, Postoperative pain, total knee arthroplasty, Home regional, Fast track arthroplasty
Brief summary
Patients scheduled to undergo total knee arthroplasty will receive motor sparing knee blocks with continuous adductor canal block along with multimodal analgesia started pre-operatively and continued into the postoperative period. The study will evaluate the feasibility of home discharge within the first 24 hours following total knee arthroplasty. We will also evaluate the pain scores in the first 5 days following the surgery, causes of delayed discharge and any adverse events.
Interventions
PROCEDUREAdductor canal block
All patients will recieve fast tracking with reduced fasting times, multimodal analgesia and adductor canal block
Sponsors
London Health Sciences Centre Research Institute OR Lawson Research Institute of St. Joseph's
Study design
Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
SUPPORTIVE_CARE
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
40 Years to 70 Years
Healthy volunteers
No
Inclusion criteria
1. Male and females of 40-70years of age 2. Scheduled to undergo unilateral primary total knee arthroplasty 3. ASA Class I, II
Exclusion criteria
1. ASA 3, 4 2. Revision surgery 3. Narcotic dependent (opioid intake morphine equivalent \> 10 mg/ day for more than 3 months) 4. Other sources of chronic pain like fibromyalgia 5. Patients with associated significant cardiac, CNS or respiratory disease (poor cardio-respiratory reserve) 6. Major conduction defects in EKG (bifascilular block, CHB); significant valvular heart disease 7. Recent MI/ Stroke/ CHF (in the past 3 months) 8. BMI\> 35 9. Obstructive sleep apnea (AHI \> 15) 10. Patients with coexisting hematological disorder or with deranged coagulation parameters. 11. Patients with pre-existing major organ dysfunction such as hepatic and renal failure. 12. Psychiatric illnesses 13. Uncontrolled diabetes mellitus 14. Lack of informed consent. 15. Allergy to any of the drugs used in the study 16. Preoperative neurological deficits 17. Use of walking aids preoperatively 18. Living alone (Lack of Chaperone/home help) 19. Language barrier 20. Contralateral leg weakness 21. Pregnancy
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| percentage of patients discharged at 23 hours based on a composite of various factors represented on a pre-determined criteria | 24 hours |
Secondary
| Measure | Time frame |
|---|---|
| first 24 hour pain scores | 24 hours |
| first 96 hour pain scores | 96 hours |
| Rescue analgesic frequency | 24 hours |
| total analgesic usage in the first 24 and 96 postoperative hours | 96 hours |
Countries
Canada
Outcome results
None listed