Knee Osteoarthritis
Conditions
Keywords
adduktor canal block,knee artroplasti,postoperative pain
Brief summary
to investigate the effect of adductor canal block applied with two different approaches in the treatment of pain after TKA surgery on pain control and functional mobility.
Detailed description
This prospective randomized trial is randomly divided into 3 groups using the method. Total knee arthroplasty is performed by the same surgical team. is applied. The patients were divided into proximal ACB applied, distal ACB applied and control groups.
Interventions
All patients who will undergo adductor canal block are sedated with midazolam 0.03 mg/kg in the preoperative preparation room, after standard monitoring. After 2-3 ml skin infiltration with 2% lidocaine under sterile conditions, a block is applied under USG guidance.To verify block success, sensory function is assessed by pinprick testing along the saphenous nerve distribution by comparing the pinprick sensation to the unaffected limb.All patients are monitored in the operating room and in a sitting position, 10-20 mg (2-4 ml) of heavy marcaine (0.5% bupivacaine hydrochloride and dextrose monohydrate) is applied to the subarachnoid space by entering the L3-4 or L4-5 space with a 25-gauge Whitrace needle.For postoperative multimodal analgesia, which is routinely applied to all patients, intravenous PCA (patient controlled analgesia )tramadol and paracetamol 10 mg / kg iv (8 hours apart) will be given.
No nerve block procedure is applied to patients.All patients are monitored in the operating room and in a sitting position, 10-20 mg (2-4 ml) of heavy marcaine (0.5% bupivacaine hydrochloride and dextrose monohydrate) is applied to the subarachnoid space by entering the L3-4 or L4-5 space with a 25-gauge Whitrace needle.For postoperative multimodal analgesia, which is routinely applied to all patients, intravenous PCA (patient controlled analgesia) tramadol 50 mg at 10 mg / hour basal rate after loading (20 mg bolus dose + 30 minutes lock time) and paracetamol 10 mg / kg iv (8 hours apart) will be given.
Sponsors
Study design
Intervention model description
three groups Group 1: proximal ACB (n:26) Group 2: distal ACB(n:26) Group 3: Control group (n:26)
Eligibility
Inclusion criteria
* Medications for unilateral TKA surgery * Patients aged 18-85 * ASA 1-3
Exclusion criteria
* Patients under 18 years of age and over 85 years of age * Patients with ASA 4 and above * Patients with cognitive impairment * Patients with application site infection * Patients allergic to local anesthesia * Patients receiving anticoagulant therapy * Patients with bleeding diathesis * Patients with chronic opioid or substance use * Patients with insulin-dependent diabetes mellitus * patients with neuropathy * patients with hepatic or renal failure * Patients who do not accept the procedure to be applied
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| VISUAL ANALOGUE SCALE(VAS) | POSTOPERATIVE 6, 12 AND 24 HOURS | VAS pain score was evaluated as no pain (score=0) and worst pain (score=10) and was divided into 3 groups according to the World Health Organization's pain intensity scale: score \<3 mild pain, 3-6 mild-moderate. degree pain and \>6 moderate-severe pain. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| first mobilization time | within postoperative 24 hours | The first postoperative mobilization hours of the patients will be recorded. |
| length of hospital stay | ONE WEEK | The time between patients' admission and discharge will be recorded. |
| opioid use | within postoperative 24 hours | Intravenous PCA will be applied to each patient and the total tramadol dose spent will be calculated.intravenous PCA (patient controlled analgesia) tramadol 50 mg at 10 mg / hour basal rate after loading (20 mg bolus dose + 30 minutes lock time) |
Countries
Turkey (Türkiye)