Adductor Canal Block, Dual Subsartorial Block, Femoral Nerve Block, Postoperative Analgesia, Total Knee Arthroplasty
Conditions
Brief summary
This study aims to compare the effect of dual subsartorial block (DSB), adductor canal block (ACB), and femoral nerve block (FNB) for postoperative analgesia in patients undergoing total knee arthroplasty (TKA).
Detailed description
Total knee arthroplasty (TKA) offers increased joint mobility and painless ambulation to patients. Femoral nerve block (FNB) is commonly used to relieve postoperative pain and opioid consumption. Adductor canal block (ACB) is a common analgesic intervention for postoperative pain control following TKA. The dual subsartorial block (DSB) is a novel procedure-specific and motor-sparing regional analgesia (RA) technique that may reduce overall postoperative opioid consumption when used in conjunction with multimodal analgesia.
Interventions
OTHERDual subsartorial block
Patients will receive dual subsartorial block (DSB).
OTHERAdductor canal block
Patients will receive an adductor canal block (ACB).
OTHERFemoral nerve block
Patients will receive a femoral nerve block (FNB).
Sponsors
Tanta University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
DOUBLE (Subject, Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
18 Years to 75 Years
Healthy volunteers
No
Inclusion criteria
* Age from 18 to 75 years. * Both sexes. * American Society of Anesthesiology (ASA) physical status I-II. * Undergoing total knee arthroplasty (TKA) under general anesthesia.
Exclusion criteria
* Severe valgus deformity. * Acute/chronic kidney disease. * Neurological deficit. * Cognitive dysfunction. * Local infection at the site of injection. * Coagulopathy. * Hypersensitivity and/or allergies to local anesthetic (LA) or any of the study medications. * Chronic opioid consumption (daily or almost daily use of opioids for \> three months). * Operative limb neuropathy.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Time to the 1st rescue analgesia | 24 hours postoperatively | Time to the first request for the rescue analgesia (time from the end of surgery to first dose of morphine administrated). |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Intraoperative fentanyl consumption | Intraoperatively | Additional fentanyl bolus dosages of 1 µg/kg IV will be administered if heart rate or mean arterial blood pressure elevated more than 20% of the baseline (after exclusion of other causes than pain). |
| Degree of pain | 24 hours postoperatively | Each patient will be instructed about postoperative pain assessment with the visual analog scale (VAS). VAS (0 represents "no pain" while 10 represents "the worst pain imaginable"). VAS will be assessed at PACU, 2, 4, 6, 8, 12, 18 and 24 h postoperatively. |
| Degree of patient satisfaction | 24 hours postoperatively | Degree of patient satisfaction will be assessed on a 5-point Likert scale patient satisfaction (1, extremely dissatisfied; 2, unsatisfied; 3, neutral; 4, satisfied; 5, extremely satisfied). |
| Incidence of adverse events | 24 hours postoperatively | Incidence of adverse events such as bradycardia, hypotension, nausea, vomiting, respiratory depression, pruritus, or any other complication. |
Countries
Egypt
Outcome results
None listed