Knee Arthroplasty, Total
Conditions
Brief summary
The investigators aimed to evaluate the efficacy of selective low volume ultrasound-guided blockades of the saphenous and obturator nerves on dynamic and rest pain 24-hours post-operatively for patients undergoing unilateral primary total knee arthroplasty.
Detailed description
A femoral nerve block is the recommended strategy in many surgical centers to supplement multimodal analgesic regime following total knee arthroplasty (TKA) (i.e. both for spinal and general anesthesia). However, a femoral nerve block will often result in quadriceps paralysis, and this will increase the risk for the patient to fall as long as the femoral block have effect. Thus, the search for sensory nerve blocks to stop pain after TKA is a very interesting topic. The saphenous nerve is a purely sensory nerve, and the posterior branch of the obturator nerve is a mixed nerve, where the motor component only affects part of the adductor major muscle.
Interventions
Ultrasound guided nerve blocks of the saphenous and obturator nerve, posterior branch with ropivacaine 0.75% for both nerve branches
DRUGnerve block with ropivacaine and with saline
nerve blocks of the saphenous nerve with ropivacaine 0.75% and obturator nerve, posterior branch with saline
DRUGnerve block with saline
Ultrasound guided nerve blocks of the saphenous and obturator nerve, posterior branch with saline for both nerve branches
Sponsors
Bispebjerg Hospital
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
QUADRUPLE (Subject, Caregiver, Investigator, Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
1. American Society of Anesthesiologists' physical classification I-III 2. Age ≥ 18 years undergoing primary unilateral total knee arthroplasty
Exclusion criteria
1. Inability to cooperate 2. Inability to speak and understand Danish 3. Allergy to any drugs used in the study 4. Drug or alcohol abuse 5. Pregnancy or nursing 6. Opioid abusers
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Dynamic pain (pain upon movement) quantified as area-under-the-curve (AUC) 24-hours post-operatively | 24 hours | NRS 0-10 |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Total opioid consumption | 24 hours | mg |
| Nausea and vomiting | 24 hours | NRS 0-10 |
| Pain at rest quantified as area-under-the-curve (AUC) 24-hours post-operatively | 24 hours | NRS 0-10 |
| Length of stay in recovery and hospital | 72 hours | hours |
| Number of clinical complications | 72 hours | total number |
| Time to first mobilization | 24 hours | hours |
Outcome results
None listed