Knee Stiffness After Total Knee Arthroplasty
Conditions
Keywords
knee arthroplasty, spinal anesthesia, general anesthesia
Brief summary
The purpose of this study is to determine if changing the type of anesthesia improves the outcomes of manipulation and pain control after the procedure. The study will compare a spinal anesthesia with a general anesthesia, to see if there is a better outcome from either anesthesia type.
Interventions
PROCEDURESpinal Anesthesia
Administration of spinal anesthesia for knee manipulation.
PROCEDUREGeneral Anesthesia
Administration of general anesthesia for knee manipulation.
DRUGPropofol
Patients undergoing general anesthesia will receive an induction dose of propofol that will be titrated to effect, and airway support as needed until the patient is appropriately anesthetized for the procedure as determined by the anesthesia and surgical care teams.
DRUGChloroprocaine
Patients undergoing spinal anesthesia will receive a spinal injection under standard aseptic technique, with 45mg chloroprocaine.
Sponsors
Duke University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
SINGLE (Outcomes Assessor)
Masking description
Investigator and surgeon will be masked
Eligibility
Sex/Gender
ALL
Age
18 Years to 75 Years
Healthy volunteers
No
Inclusion criteria
Inclusion: 1. Patients ≥18 years presenting for a manipulation of knee joint under anesthesia. 2. ASA Classification I - III. 3. English speaking patients. Exclusion: 1. ASA 4 or 5 2. Daily chronic opioid use (over 3 months of continuous opioid use). 3. Inability to communicate pain scores or need for analgesia. 4. Infection at the site of block placement 5. Age under 18 years old or greater than 75 years old 6. Pregnant women (as determined by point-of-care serum bHCG) 7. Intolerance/allergy to local anesthetics 8. Weight \<50 kg 9. Suspected, or known addiction to or abuse of illicit drug(s), prescription medicine(s), or alcohol within the past 2 years. 10. Uncontrolled anxiety, schizophrenia, or other psychiatric disorder that, in the opinion of the investigator, may interfere with study assessments or compliance. 11. Current or historical evidence of any clinically significant disease or condition that, in the opinion of the investigator, may increase the risk of surgery or complicate the subject's postoperative course. 12. BMI \>50 kg/m2. 13. Allergy or contraindication to local anesthetics or any component of the multimodal analgesic regimen (NSAIDs and acetaminophen) 14. Contraindication to spinal injection
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Change in degrees of motion of the affected knee | At time of procedure completion |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Change in pain | Baseline, 24 hours, 48 hours, 72 hours post-procedure | Participants will be asked to rate pain on a scale of 0-10 with 0 being no pain and 10 being the worst possible pain. |
| Opioid use in PACU | Day 3 | — |
Contacts
PRINCIPAL_INVESTIGATOREmily Hall
Duke University
Outcome results
None listed