Knee Arthropathy, Knee Osteoarthritis, Knee Pain Chronic
Conditions
Brief summary
Effect of iPACK block on NLR and PLR following knee arthroplasty
Detailed description
The NLR is a sensitive indicator of inflammation confirmed in numerous studies and has a predictive and prognostic value. NLR is a cheap, simple, fast-acting, readily available stress and inflammation parameter with high sensitivity and low specificity. Dynamic changes in the NLR precede the clinical state for several hours and may alert clinicians early about the ongoing pathological process. NLR is a new promising marker of cellular immune activation, an important indicator of stress and systemic inflammation. It opens a new dimension for clinical medicine to understand better the biology of inflammation, the linkage, and antagonism between innate and adaptive immunity, and its clinical consequences for health and disease. NLR is affected not only by surgical trauma but also by the method of anesthesia. In recent years, the influence of regional anesthesiology on reducing the inflammatory response after surgical procedures has been emphasized. However, there have been very few studies evaluating the effect of various methods of anesthesia on the NLR. This is the first study to investigate the effect of regional anesthesia on the NLR and PLR in patients undergoing knee replacement surgery.
Interventions
DRUG0.9% Sodium Chloride Injection
After spinal anesthesia, the ultrasound-guided iPACK block will be performed with 20ml of 0.9% sodium chloride
DRUGRopivacaine 0.2% Injectable Solution
After spinal anesthesia, the ultrasound-guided iPACK block will be performed with 20ml of 0.2% ropivacine
Sponsors
Poznan University of Medical Sciences
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
TRIPLE (Subject, Caregiver, Investigator)
Eligibility
Sex/Gender
ALL
Age
20 Years to 90 Years
Healthy volunteers
No
Inclusion criteria
* Patients with ASA classification I-III * Aged 20-90 years * Who will be scheduled for hip arthroplasty under spinal anesthesia
Exclusion criteria
* Patients who have a history of bleeding diathesis * Take anticoagulant therapy * History of chronic pain before surgery * Multiple trauma * patients unable to assess their pain (dementia) * patients operated under general anesthesia * patients having an infection in region of the procedure * patient who do not accept the procedure
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Neutrophil-to-lymphocyte ratio | 12 hours after surgery | Neutrophil to lymphocyte ratio (NLR) is used as a marker of subclinical inflammation. It is calculated by dividing the number of neutrophils by number of lymphocytes, usually from peripheral blood sample, but sometimes also from cells that infiltrate tissue, such as tumor. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| PLR | 12 hours after surgery | Platelet-to-lymphocyte ratio |
| NLR | 24 hours after surgery | Neutrophile-to-lymphocyte ratio |
| first need of opiate | 48 hours after procedure | Time after surgery when the patient needs opiate for the first time |
| Opioid Consumption | 48 hours after surgery | Total opiate consumption after surgery |
| Pain score | 4 hours after surgery | NRS (Numerical Rating Scale) |
Countries
Poland
Outcome results
None listed