A Randomised Controlled Trial Comparing Single Shot Adductor Canal Block With Local Infiltration Analgesia for Postoperative Analgesia After Total Knee Arthroplasty

NCT02104934 | Completed

• 1 other identifier: CGHLIAACB2013
• Study Type: interventional
• Target: 40
• Locations: 1 country
• Sites: 1

Brief Summary

Total knee arthroplasty or replacement (TKA), a commonly performed surgery for osteoarthritis of the knee, is a painful procedure and requires a multimodal analgesic approach. A method for analgesia is local infiltration analgesia (LIA), where a mixture of drugs is injected around the knee joint. Adductor canal block (ACB) is an alternative regional anaesthesia technique which has been shown to result in minimal thigh weakness. The investigators aim to study if the analgesia provided by ACB is superior to LIA while preserving quadriceps strength.

Conditions

Analgesia in Total Knee Arthroplasty

Outcome Measures

Primary Outcomes (1)

• Morphine consumption in the first 24 hours

  morphine consumption in the first 24 hours (including morphine administered in recovery and via PCA).

  24 hours

Secondary Outcomes (5)

• Pain Scores

  1, 6, 12, 24 hours; up to 48 hours postoperative

• Morphine Consumption

  At 48 hours

• Postoperative Nausea and Vomiting

  Up to 48 hours

• Sedation Scores

  Up to 48 hours

• Quadriceps Strength

  at 24 and 48 hours

Other Outcomes (2)

• Presence of Complications

  up to 48 hours

• Length of Hospital Stay

  Up to 30 days

Study Arms (2)

Local Infiltration Analgesia

NO INTERVENTION

The Local Infiltration Analgesia group will receive local infiltration of ropivacaine 150mg, ketorolac 30mg, morphine 10mg, adrenaline 200mcg and vancomycin 500mg in a total volume of 75mls by the surgeon.

Adductor Canal Block

ACTIVE COMPARATOR

The Adductor Canal Block group of patients will receive intravenous ketorolac 30mg intra-operatively and an adductor canal block at the end of surgery. The block will be performed under real time ultrasound guidance and 30mls of 0.5% ropivacaine (150mg) is injected with a Stimuplex A100, 21G needle.

Procedure: Adductor Canal Block

Interventions

Adductor Canal Block PROCEDURE

Adductor Canal Block

Eligibility Criteria

• Age: 45 Years - 85 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Patients scheduled for primary TKA under single shot spinal anaesthesia, between ages 45-85 years old, American Society of Anesthesiologists (ASA) physical status 1 to 3 and BMI 18-35 kg/m2

You may not qualify if:

• Patients unable to give consent, inability to communicate/ cooperate, patients with regular consumption of strong opioids (morphine, oxycodone) or steroids, allergy to local anaesthetics or any drugs included in the study, patients with lower limb surgery in the preceding year, patients with pre-existing neurological deficits and patients who have contraindications for spinal anaesthesia.

Sponsors & Collaborators

• Changi General Hospital: lead

Study Sites (1)

Changi General Hospital

Singapore, Singapore

Location

Study Officials

• Yean Chin Lim, MBBS

  Changi General Hospital

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: DOUBLE
• Who Masked: PARTICIPANT, OUTCOMES ASSESSOR
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: March 18, 2014
• First Posted: April 7, 2014
• Study Start: March 1, 2014
• Primary Completion: December 1, 2015
• Study Completion: March 1, 2016
• Last Updated: April 25, 2017

Record last verified: 2015-07

Locations

SG (1)