Anterior Cruciate Ligament Injury, Anterior Cruciate Ligament Rupture, Postoperative Pain
Conditions
Brief summary
A lot of patient have posterior knee pain after ACL reconstruction despite saphenous nerve block. Recently a new block has been described, know as IPACK block (interspace between the popliteal artery and the capsule of the posterior knee). The objective of this randomized controlled double-blinded trial is to assess whether a combined saphenous nerve block with IPACK block is more effective for the postoperative pain than a local infiltration analgesia.
Detailed description
The saphenous nerve and the iPACK will be performed after general anaesthesia induction and before the surgery under ultrasound-guidance. The local infiltration analgesia will be performed by the surgeon during the surgery.
Interventions
DRUGRopivacaine injection
Saphenous nerve block with 20ml of ropivacaine 0.5% and IPACK block with 30ml of ropivacaine 0.2% (total dose of 160 mg).
Sponsors
Centre Hospitalier Universitaire Vaudois
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
TRIPLE (Subject, Investigator, Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Statut ASA I-III. * Patient scheduled for anterior crutiate ligament reconstruction under general anesthesia.
Exclusion criteria
* Pregnancy. * Contraindication to local anesthesia. * Patient with chronic pain, opioid consumption or alcohol consumption. * Patient with coagulation trouble, hepatic dysfunction or renal dysfunction. * Patient with diabetic or femoral neuropathy.
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Total morphine consumption (mg) | 24 hours postoperatively |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Pain scores (numeric rating scale, 0-10) at rest and on movement | 2hours, 24hours, 48hours and 72hours postoperatively | 0= no pain, 10=the worst pain imaginable |
| Rate of postoperative nausea and vomiting | 2hours, 24hours, 48hours and 72hours postoperatively | Yes/No |
| Rate of antiemetic consumption | 2hours, 24hours, 48hours and 72hours postoperatively | Yes/No |
| Rate of pruritus | 2hours, 24hours, 48hours and 72hours postoperatively | Yes/No |
| Total morphine consumption (mg) | 2 hours, 48 hours and 72 hours postoperatively | — |
| Quadriceps muscle strength (numeric scale, 1-5) | 24hours, 48hours and 72hours postoperatively | 1=no contraction, 5=normal strength |
| Distance walked (meters) | 24 hours, 48hours and 72hours postoperatively | — |
| Anterior Cruciate Ligament - Return to Sport after Injury survey | 4 and 8 postoperative months | — |
| International Knee Documentation Committee score | 4 and 8 postoperative months | — |
| Active flexion | 24hours, 48hours and 72hours postoperatively | Flexion of the knee by the patient measured in degrees |
Countries
Switzerland
Outcome results
None listed