Quadriceps Strength, VAS Score
Conditions
Keywords
Total knee arthroplasty, Adductor canal block, Hydromorphone, Ropivacaine, Multimodal Analgesia, Postoperative analgesia
Brief summary
This study proposes a multimodal analgesia regimen comprising preoperative non-steroidal anti-inflammatory drugs (NSAIDs) for preemptive analgesia, intra-articular injection at the end of surgery, and postoperative adductor canal block. The objective is to observe the analgesic efficacy and duration of hydromorphone combined with ropivacaine in the adductor canal block on resting and movement-related pain in patients following total knee arthroplasty, as well as the time to recovery from motor blockade and the incidence of drug-related adverse events.
Interventions
DRUGHydromorphone
Ultrasound-guided single-shot ACB with 0.5 mg hydromorphone
DRUGRopivacaine
Ultrasound-guided single-shot adductor canal block (ACB) with 20 mL of 0.5% ropivacaine
Sponsors
China-Japan Friendship Hospital
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
QUADRUPLE (Subject, Caregiver, Investigator, Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
60 Years to 75 Years
Healthy volunteers
No
Inclusion criteria
1. ASA physical status I-III; 2. Undergoing elective unilateral primary total knee arthroplasty (TKA); 3. Implementing the ERAS protocol 4. Body-mass index (BMI) of 18.5-32.0 kg/m²; 5. Provided written informed consent.
Exclusion criteria
1. Allergy to amide local anaesthetics or opioids; 2. Chronico or disorder opioid use; 3. Pre-existing central and peripheral nerve injuries； 4. Lower limb muscle weakness 5. Unable to cooperate with VAS pain assessment 6. Contraindications for nerve block include infection at the puncture site.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Visual Analog Scale (VAS) Pain Score | Preoperatively and at 4, 8, 12, and 24 hours postoperatively | The co-primary outcomes consisted of resting pain score and dynamic pain score during active 45° knee flexion measured by the Visual Analog Scale (VAS). The scale ranges from a minimum value of 0 points (no pain) to a maximum value of 10 points (the worst imaginable pain); higher scores indicate more severe pain. Assessments were conducted at baseline before surgery, and at 4 hours, 8 hours, 12 hours and 24 hours after surgery. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Quadriceps strength | Preoperatively and at 4, 8, 12, and 24 hours postoperatively | Secondary outcomes were quadriceps strength (Lovett scale, 0-5) before surgery and at 4, 8, 12, and 24 hours after surgery. |
| Postoperative analgesia-related adverse reactions | At 4, 8, 12, and 24 hours postoperatively | — |
| Postoperative opioid use | At 4, 8, 12, and 24 hours postoperatively | — |
Countries
China
Outcome results
None listed