Knee Pain
Conditions
Brief summary
Patient with atraumatic knee pain without a large knee effusion on x-ray will be randomized to receive either a genicular nerve block (GNB) or standard of care in the emergency department.
Interventions
genicular nerve block with ideal body-weight dosing of bupivacaine 0.5% with 4 mg dexamethasone
OTHERStandard of Care
This involves standard of care pain relief for patients who do not receive the genicular nerve block for knee pain, such as acetaminophen, non-steroidal anti-inflammatory drugs (NSAIDs), and opioids.
Sponsors
University of Pennsylvania
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Atraumatic knee pain * \>17 years age * X-ray of the knee obtained in the ED * Initial pain score (numeric rating scale) 5-10
Exclusion criteria
* Fracture or dislocation on x-ray * large knee joint effusion identified on x-ray * allergy or contraindication to local anesthetics * History of local anesthetic systemic toxicity after receiving local anesthetics * Pregnancy * Incarcerated * History of knee replacement of affected knee * Concern for septic joint * Overlying cellulitis * Hemodynamic instability * Altered mental status or inability to consent for procedure.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Pain level | 1 hour post-enrollment | Measured by numeric rating scale: 0 (minimum value) - 10 (maximum value) |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Difference in Duration of Analgesia | 24 hours | Patients will be called back to assess their pain levels |
| Difference in AP-POQ-RED score | 1 hour after enrollment | 9 question survey study, all questions rated on 0 (minimum) - 10 (maximum) scale. Questions include: pain before and after treatment, pain with activities in and out of bed, emotions (anxiety, fear, helplessness), degree of pain relief in the emergency department, satisfaction. |
| Difference in length of stay in the emergency department | Average 1 hour | Length of stay in the emergency department is determined from the time the provider first sees the patient to the time the provider discharges the patient. |
Countries
United States
Contacts
CONTACTUmar Clinical Research Coordinator, AB
PRINCIPAL_INVESTIGATORMichael M Shalaby, MD
University of Pennsylvania
Outcome results
None listed