Knee Arthritis, Knee Osteoarthritis, Knee Pain Chronic
Conditions
Brief summary
Effect of Erector Spinae Plane Block and iPACK block with Adductor Canal Block on pain management, and NLR and PLR following knee arthroplasty
Detailed description
Knee arthroplasty is one of the most common orthopedic procedures, especially in elderly patients, due to the deformation of joints. Patients may complain of severe pain due to surgical trauma and prosthesis. Regional anesthesia methods may be performed to reduce the inflammatory response, opioid consumption, and opioid-related side effects. In recent years, the influence of regional anesthesiology on reducing the inflammatory response after surgical procedures has been emphasized. However, very few studies have evaluated the effect of various methods of anesthesia on the NLR.
Interventions
DRUGControl Test - spinal anesthesia
No peripheral nerve block Only spinal anesthesia
DRUGRopivacaine 0.2% Injectable Solution ESPB
ultrasound guided erector spinae plane block (ESPB) - L2 level, unilateral
DRUGRopivacaine 0.2% Injectable Solution iPACK+ACB
ultrasound guided iPACK block + Adductor Canal Block
Sponsors
Poznan University of Medical Sciences
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
TRIPLE (Subject, Caregiver, Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
18 Years to 100 Years
Healthy volunteers
No
Inclusion criteria
* Patients with ASA classification I-III, * Aged 20-100 years, * scheduled for knee arthroplasty under spinal anaesthesia
Exclusion criteria
* Patients who have a history of bleeding diathesis, * Take anticoagulant therapy, * have a History of chronic pain before surgery, * have Multiple trauma, * cannot assess their pain (dementia), * have been operated on under general anaesthesia, * have an infection in the area * do not accept the procedure
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Opioid consumption | 48 hours | Total opiate consumption after surgery |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| first need of opiate | 48 hours | Time after surgery when the patient needs opiate for the first time |
| Numerical Rating Scale [range 0:10] | 4 hours after surgery | Postoperative pain assessment will be performed using the NRS score (0 = no pain, 10 = the most severe pain felt) |
| NLR | 24 hours postoperatively | Neutrophil-to-lymphocyte ratio |
| PLR | 24 hours postoperatively | Platelet-to-lymphocyte ratio |
| Quadriceps muscle strength assessed using medical research council scale [range 0:5] | 24 hours after surgery | Quadriceps muscle strength (knee extension and hip adduction) will be evaluated according to the medical research council muscle strength rating |
Countries
Poland
Outcome results
None listed