OA Knee going on total knee arthroplasty -Steroids -methylprednisolone -Peripheral nerve block - Motor-sparing nerve block -Postoperative Pain -Analgesia -Total Knee Arthroplasty
Conditions
Interventions
Single-shot iPACK block is perform by Methylprednisolone sodium succinate (40mg/1ml) 1 mL + 0.5% bupivacaine 10 mL + adrenaline 1:200,000 0.3 mL + normal saline up to 20 mL
Continuous adductor canal
Experimental Procedure/Surgery,Experimental Procedure/Surgery
Methylprednisolone with local anesthetic drug group, local anesthetic drug alone group
Sponsors
none
Eligibility
Sex/Gender
All
Age
50 Years to 75 Years
Inclusion criteria
Inclusion criteria: Patient who was scheduled for total knee arthroplasty at King Chulalongkorn Memorial Hospital ASA class 1 to 3 ASA class 1 A normal healthy patient ASA class 2 A patient with mild systemic disease Mild diseases only without substantive functional limitations ASA class 3 A patient with severe systemic disease but not threaten to life Body mass index BMI between 18 to 40 kg m2
Exclusion criteria
Exclusion criteria: refuse to participate this study unable to cooperate or cognitive impairment eg dementia allergy to any drug in this study contraindication to methylprednisolone contraindication to neuraxial anesthesia eg coagulopathy contraindication to NSAIDs Ketorolac and Celebrex in this study poor controlled diabetic mellitus (HBA1C>8) hepatic and/or renal insufficiency chronic opioids use or diagnosed of neuropathic pain unable to performed Time up and go test
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Incidence of moderate-severe pain through 14 day after surgery (from discharge until postoperative day 14) Percentage of NRS score 4 to 6 | — |
Secondary
| Measure | Time frame |
|---|---|
| postoperative pain score of knee pain at rest post operative day 0-14 and week 3-12 Numerical pain rating scale,postoperative pain score of knee pain on movement post operative day 0-14 and week 3-12 Numerical pain rating scale,postoperative nausea and vomitting post operative day 0-2 Visual analog scale ,quality of sleep post operative day 0-7 Likert scale,quadriceps muscle strength postoperative day 1,2 digital dynamometer,Degree of knee flexion and extension Postoperative 0, 1, 2 Days Degree of range of motion,Timed up and go test, KSS, 5 times sit to stand , 2 mins walk test Postoperative 1, 2 days and 2 , 6 weeks and 3 month Rehabilitation after surgery,Incidence of rebound pain after ACB catheter was removed percentage of NRS more than 6,Incidence of moderate-severe pain 2 weeks to 1 month and 1 month to 3 months after surgery Percentage of NRS score 4 to 6 | — |
Countries
Thailand
Contacts
Public ContactPiraya Akaravinek
Faculty of medicine, Chulalongkorn university
Outcome results
None listed