ACL Tear, Pain, Postoperative
Conditions
Brief summary
Anterior cruciate ligament repair (ACL) surgery presents moderate to severe pain during the inmediate postoperative period and the first days after surgery. In addition, due to the interest of surgeons and patients for early reinstatement, the use of blockages that decrease the strength of the quadriceps is avoided. Therefore, in recent years, the adductor canal block (ACB) has been used for postoperative analgesia with variable results. Genicular nerve block (GNB) has been used for pain management in patients with knee osteoarthritis and recently in knee arthroplasty surgery with results similar to the local anesthetic infiltration techniques by the surgeon (LIA). Considering their good results in these patients in addition to being a 100% sensitive block without risk of motor involvement. The investigators proposed this experimental study to evaluate tha analgesic efficacy of the genicular nerve block (GNB) compared with the adductor canal block (ACB) for the Anterior cruciate ligament (ACL) repair surgery.
Detailed description
Participants scheduled to undergo anterior cruciate ligament reconstruction under general anaesthesia will be allocated to two groups: Adductor canal block or Genicular nerve block- The adductor canal block will be performed by the anaesthesiologist under ultrasound guidance prior the surgery, after inducction , using 20 mLs Ropivacaine 0.2%. The genicular nerve block will be performed by the anaesthesiologist under ultrasound guidance prior the surgery, after inducction , using 20 mLs Ropivacaine 0.2% in total. Postoperative analgesia will include analgesia (Dexketoprofen 75 mg during first 24 hours), acetomiophen 1 gr every 8 hours and tramadol for rescue pain.
Interventions
PROCEDUREAdductor canal block
Injection of the local anesthetic prior to the surgery, either in the the adductor canal or in the genicular nerves by the anesthesiologist under ultrasound guidance.
Sponsors
Hospital Clinic of Barcelona
Study design
Allocation
NON_RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
TRIPLE (Subject, Caregiver, Outcomes Assessor)
Intervention model description
UNIcenter Non-randomized trial
Eligibility
Sex/Gender
ALL
Age
18 Years to 50 Years
Healthy volunteers
No
Inclusion criteria
* Patients from 18 to 50 years old scheduled to undergo anterior cruciate ligament reconstruction
Exclusion criteria
* peripheral neuropathy * pre-existing femoral neuropathy * diabetes mellitus * alcoholism * drug addiction * cancer with chemotherapy * chronic pain state * Negative of the patient to participate in the study.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Pain assessed by NRS at PACU | up to 6 hours postoperative | Numerical raiting score (NRS) 0-10 (0= No pain; 10=maximum pain) |
| Opioid consumption at PACU | up to 6 hours postoperative | Metadone consumption in mg. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Pain score at home | up to 24 hours | Numerical raiting score (NRS) 0-10 (0= No pain; 10=maximum pain) |
| Quality of rest | First night | Sleep or wake-up during first night (Pain) (Awake because of pain: Yes / NO) |
Countries
Spain
Outcome results
None listed