Postoperative Pain
Conditions
Brief summary
This study will compare the analgesic efficacy of daily single-shot adductor canal block(ABC) versus continuous ACB after total knee arthroplasty (TKA).
Detailed description
Patients 19-75 years old, of ASA classification I-III scheduled for unilateral TKA, will be enrolled and randomized into two groups, single-shot ACB group and continuous ACB group. In both groups, participants will be administered a single-shot ACB immediately after the end of the operation. The single-shot ACB group will receive two separate single-shot ACBs, on the first and second postoperative day. A nerve block catheter will be placed in patients in the continuous ACB group, which will be connected to a patient-controlled analgesia pump until the second postoperative day. The primary outcome of this study is the average NRS pain score at rest from the end of surgery to 2 days after surgery.
Interventions
PROCEDURESingle shot adductor canal block
Single shot adductor canal block on the the first and second postoperative day.
PROCEDUREContinuous adductor canal block
A catheter will be placed in the adductor canal and connected to a continuous patient-controlled analgesia pump.
Sponsors
Seoul National University
Seoul National University Hospital
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
SINGLE (Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
19 Years to 75 Years
Healthy volunteers
Yes
Inclusion criteria
* ASA classification I, II, III * Patients scheduled for unilateral knee arthroplasty
Exclusion criteria
* Anesthesia other than spinal anesthesia * Chronic opioid use * Uncontrolled diabetes of HbA1c\>7.5 * Neuromuscular pathology of the ipsilateral leg * Second-look knee arthroplasty * Inability to communicate (e.g. dementia) * Hypersensitivity to ropivacaine * BMI \> 40 * Pregnancy
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Average NRS pain score at rest | first 48h after end of surgery | average of numerical rating scale (0: no pain, 10: worst imaginable pain) pain scores from 8 time points during 48h (+4h, +8h, +12h from end of surgery, 6AM, 2PM, 10PM of postoperative day 1, and 6AM and 2PM of postoperative day 2) |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| numerical rating scale (0: no pain, 10: worst imaginable pain) pain score at rest at +4h from end of surgery | +4h from end of surgery | — |
| numerical rating scale (0: no pain, 10: worst imaginable pain) pain score during movement at +4h from end of surgery | +4h from end of surgery | — |
| NRS pain score at rest at +8h from end of surgery | +8h from end of surgery | — |
| numerical rating scale (0: no pain, 10: worst imaginable pain) pain score during movement at +8h from end of surgery | +8h from end of surgery | — |
| numerical rating scale (0: no pain, 10: worst imaginable pain) pain score during movement at +12h from end of surgery | +12h from end of surgery | — |
| numerical rating scale (0: no pain, 10: worst imaginable pain) pain score at rest at 6AM on postoperative day 1 | 6AM on postoperative day 1 | — |
| numerical rating scale (0: no pain, 10: worst imaginable pain) pain score during movement at 6AM on postoperative day 1 | 6AM on postoperative day 1 | — |
| NRS pain score at rest at 2PM on postoperative day 1 | 2PM on postoperative day 1 | — |
| NRS pain score during movement at 2PM on postoperative day 1 | 2PM on postoperative day 1 | — |
| NRS pain score at rest at 10PM on postoperative day 1 | 10PM on postoperative day 1 | — |
| numerical rating scale (0: no pain, 10: worst imaginable pain) pain score during movement at 10PM on postoperative day 1 | 10PM on postoperative day 1 | — |
| numerical rating scale (0: no pain, 10: worst imaginable pain) pain score at rest at +12h from end of surgery | +12h from end of surgery | — |
| NRS pain score during movement at 6AM on postoperative day 2 | 6AM on postoperative day 2 | — |
| numerical rating scale (0: no pain, 10: worst imaginable pain) pain score at rest at 2PM on postoperative day 2 | 2PM on postoperative day 2 | — |
| numerical rating scale (0: no pain, 10: worst imaginable pain) pain score during movement at 2PM on postoperative day 2 | 2PM on postoperative day 2 | — |
| Posteoperative opioid administration in morphine equivalents | from end of surgery to 48h after surgery | — |
| Incidence of catheter tip dislocation | at 2PM on postoperative day 1 and 2 | The catheter tip is considered to be dislocated if the catheter tip is located outside the adductor canal |
| Incidence of extravasation from catheter insertion site | at 2PM on postoperative day 1 and 2 | — |
| Incidence of sleep disturbance due to pain | from end of surgery to postoperative day 2 | — |
| Incidence of numbness of anterior thigh area | at 2PM on postoperative day 1 and 2 | — |
| Strengh of quadratus femoris muscle (unit: kgf) | at 2PM on postoperative day 1 and 2 | — |
| Incidence of falls during hospital stay | from end of surgery to 48h after surgery | — |
| Postoperative range of motion of knee joint | at 2PM on postoperative day 1 and 2 | — |
| numerical rating scale (0: no pain, 10: worst imaginable pain) pain score at rest at 6AM on postoperative day 2 | 6AM on postoperative day 2 | — |
Countries
South Korea
Outcome results
None listed