Total Knee Arthroplasty
Conditions
Keywords
arthroplasty, replacement, knee
Brief summary
100 patients ASA I-III, undergoing total knee arthroplasty under spinal anesthesia, will be randomly assigned into one of two groups, namely group A (n=50), where an adductor canal block and an IPACK block will be performed preoperatively and group B (n=50) where an adductor canal block only will be performed preoperatively. All patients will receive a standardized multimodal approach, including pregabalin, paracetamol, and PCA with morphine. NRS scores in static and dynamic conditions during the first 48 hours postoperatively, morphine consumption during the first 24 hours postoperatively will be measured and additionally, patient satisfaction, complications, range of knee motion, moblization, functionality, delirium ocurence will be recorded. Chronic pain will be assessed in 3 and 6 months postoperatively.
Interventions
Adductor Canal Block plus IPACK Block using Ropivacaine
DRUGAdductor Canal Block
Adductor Canal Block using Ropivacaine
Sponsors
Aikaterini Kalampokini
Chryssoula Staikou
Asklepieion Voulas General Hospital
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
TRIPLE (Subject, Investigator, Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
14 Years to 80 Years
Healthy volunteers
No
Inclusion criteria
* Physical status according to American Society of Anesthesiologists (ASA) I-III * Patients scheduled for total knee arthroplasty
Exclusion criteria
* Previous operation on same knee * Contraindication of spinal anesthesia, peripheral nerve blocks or any of the agents used in the protocol * BMI above 32 * Serious psychiatric, mental and cognitive disorders * Language barrier * Block failure * Chronic opioid, gabapentinoid use * Severe kidney disfunction
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| NRS scores | 48 hours | Numerical Rating Scale (NRS) scores (Range 0-10, 0=no pain, 10=the worse pain ever) |
| Morphine consumption | 24 hours | Morphine consumption in mg |
| Chronic pain | 6 months | Using of Graded Chronic Pain Scale (GCPS) Grade 0: No pain in prior 6 months Grade 1: Low Intensity - Low Disability Grade II: High Intensity Characteristic Pain Intensity - Low Disability Grade III: High Disability - Moderately Limiting Grade IV: High Disability - Severely Limiting |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Patient mobilization | 5 days | Patient reporting time of first standing to the side of the bed and number of steps per day |
| Patient satisfaction | 48 hours | Patients asked whether they would choose the same anaesthetic management in a future operation: Yes/No |
| Delirium occurence | 48 hours | Nu-DESK scale (presence of disorientation, inappropriate behavior, inappropriate communication,illusions/hallucinations, psychomoter retardation). Each of the 5 items is rated from 0 to 2. A total of 10 is the maximum score. A score of more than 2 identifies the presence of delirium. |
| Intestinal function | 5 days | Time of first passing of rectal gas, reported by the patient |
| Joint function | 6 months | Maximal flexion / extension |
| Range of knee motion | 48 hours | Degrees of flexion |
| Complications | 48 hours | — |
Countries
Greece
Contacts
Primary ContactAlexandros Makris
Outcome results
None listed