NCT02540070

Brief Summary

Patients undergoing primary total knee replacement will receive either motor sparing knee block to be performed by anesthesia or periarticular local anesthetic infiltration at the end of surgery by surgeons to assess pain relief as well as capacity to ambulate early. The motor sparing knee block will be performed prior to surgery using ultrasonography and the effect of adding dexmedetomidine, an alpha 2 agonist to the injectate with regards to prolonging the duration of analgesia will be assessed.

Trial Health

55
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Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Enrollment
135

participants targeted

Target at P25-P50 for phase_3

Geographic Reach
1 country

1 active site

Status
unknown

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

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Study Timeline

Key milestones and dates

First Submitted

Initial submission to the registry

March 17, 2014

Completed
5 months until next milestone

Study Start

First participant enrolled

August 1, 2014

Completed
1.1 years until next milestone

First Posted

Study publicly available on registry

September 3, 2015

Completed
2.2 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

December 1, 2017

Completed
Last Updated

November 15, 2016

Status Verified

August 1, 2015

Enrollment Period

3.3 years

First QC Date

March 17, 2014

Last Update Submit

November 11, 2016

Conditions

Keywords

Adductor canal Blockultrasoundperiarticular injectionsDexmedetomidine

Outcome Measures

Primary Outcomes (1)

  • Duration of analgesia

    To note the duration of analgesia in the three different arms

    24 postoperative hour

Secondary Outcomes (3)

  • pain scores on movement

    every 4 hours up to 24 hours

  • pain scores at rest

    every 4 hours up to 24 hours

  • discharge criteria

    6 and 18 postoperative hours

Study Arms (3)

Periarticular

ACTIVE COMPARATOR

Patients in group 1 will receive periarticular infiltration of LA mixture (100 ml) consisting of 0.3% ropivacaine, 2.5 µg/mL of epinephrine, 10 mg of morphine and 30 mg of ketorolac at the end of surgery and sham injections of saline into the motor sparing knee blocks preoperatively.

Procedure: PeriarticularDrug: RopivacaineDrug: epinephrineDrug: morphineDrug: KetorolacDrug: saline

Motor free

EXPERIMENTAL

Patients in group 2 will receive motor sparing knee blocks with 0.5% ropivacaine with 2.5 µg/mL of epinephrine, 30 mg of ketorolac and 10 mg of morphine with a total local anesthetic volume of 60 ml (300 mg). Sham injections of saline (100 ml) will be injected periarticularly at the end of surgery.

Procedure: Motor freeDrug: RopivacaineDrug: epinephrineDrug: morphineDrug: KetorolacDrug: saline

Motor free with Dex

EXPERIMENTAL

Patients in group 3 will receive motor sparing knee blocks with 0.5% ropivacaine with 1 µg/Kg of dexmedetomidine, 30 mg of ketorolac and 10 mg of morphine with a total local anesthetic volume of 60 ml (300 mg). Patients in group 3 will receive sham injections of saline (100 ml) periarticularly at the end of surgery.

Procedure: Motor free with dexDrug: RopivacaineDrug: morphineDrug: KetorolacDrug: DexmedetomidineDrug: saline

Interventions

PeriarticularPROCEDURE
Periarticular
Motor freePROCEDURE
Motor free
Motor free with Dex
Motor freeMotor free with DexPeriarticular
Motor freePeriarticular
Motor freeMotor free with DexPeriarticular
Motor freeMotor free with DexPeriarticular
Motor free with Dex
salineDRUG
Motor freeMotor free with DexPeriarticular

Eligibility Criteria

Age18 Years - 85 Years
Sexall
Healthy VolunteersNo
Age GroupsAdult (18-64), Older Adult (65+)

You may qualify if:

  • Male and females of 18-85 years of age, scheduled to undergo elective primary total knee arthroplasty.
  • ASA Class I, II, III
  • Good contralateral leg strength

You may not qualify if:

  • ASA physical status 4 or above
  • Patients who will need hospitalization due to reason other than the planned surgery.
  • Psychiatric illnesses.
  • Revision knee surgery
  • Narcotic dependency
  • Extraneous sources of chronic pain
  • Inability to provide informed consent.
  • Allergy to any of the drugs used in the study.
  • Contraindications to blocks and multimodal analgesia
  • Wheel chair bound

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (1)

University Hospital, London Health Sciences Centre

London, Ontario, N6A 5A5, Canada

RECRUITING

Related Publications (2)

  • Fowler SJ, Christelis N. High volume local infiltration analgesia compared to peripheral nerve block for hip and knee arthroplasty-what is the evidence? Anaesth Intensive Care. 2013 Jul;41(4):458-62. doi: 10.1177/0310057X1304100404.

    PMID: 23808503BACKGROUND
  • Abdallah FW, Brull R. Facilitatory effects of perineural dexmedetomidine on neuraxial and peripheral nerve block: a systematic review and meta-analysis. Br J Anaesth. 2013 Jun;110(6):915-25. doi: 10.1093/bja/aet066. Epub 2013 Apr 15.

    PMID: 23587874BACKGROUND

MeSH Terms

Conditions

OsteoarthritisAgnosia

Interventions

RopivacaineEpinephrineMorphineKetorolacDexmedetomidineSodium Chloride

Condition Hierarchy (Ancestors)

ArthritisJoint DiseasesMusculoskeletal DiseasesRheumatic DiseasesPerceptual DisordersNeurobehavioral ManifestationsNeurologic ManifestationsNervous System DiseasesSigns and SymptomsPathological Conditions, Signs and Symptoms

Intervention Hierarchy (Ancestors)

AnilidesAmidesOrganic ChemicalsAniline CompoundsAminesEthanolaminesAmino AlcoholsAlcoholsBiogenic MonoaminesBiogenic AminesCatecholaminesCatecholsPhenolsBenzene DerivativesHydrocarbons, AromaticHydrocarbons, CyclicHydrocarbonsMorphine DerivativesMorphinansOpiate AlkaloidsAlkaloidsHeterocyclic CompoundsHeterocyclic Compounds, Bridged-RingHeterocyclic Compounds, 4 or More RingsHeterocyclic Compounds, Fused-RingPhenanthrenesPolycyclic Aromatic HydrocarbonsPolycyclic CompoundsIndomethacinIndolesHeterocyclic Compounds, 2-RingImidazolesAzolesHeterocyclic Compounds, 1-RingChloridesHydrochloric AcidChlorine CompoundsInorganic ChemicalsSodium Compounds

Study Officials

  • Sugantha Ganapathy, FRCPC

    LHSC, UWO, Canada

    PRINCIPAL INVESTIGATOR

Central Study Contacts

Sugantha Ganapathy, FRCPC

CONTACT

Study Design

Study Type
interventional
Phase
phase 3
Allocation
RANDOMIZED
Masking
DOUBLE
Who Masked
PARTICIPANT, INVESTIGATOR
Purpose
TREATMENT
Intervention Model
PARALLEL
Sponsor Type
OTHER
Responsible Party
PRINCIPAL INVESTIGATOR
PI Title
Principal Investigator

Study Record Dates

First Submitted

March 17, 2014

First Posted

September 3, 2015

Study Start

August 1, 2014

Primary Completion

December 1, 2017

Last Updated

November 15, 2016

Record last verified: 2015-08

Locations