Adductor Canal Block Versus Femoral Nerve Block With Repeated Bolus Doses Arthroplasty

NCT03188809 | Completed

• 1 other identifier: 1
• Study Type: interventional
• Target: 42
• Locations: 1 country
• Sites: 1

Brief Summary

After total knee prosthesis surgery, in the first postopertive days, serious pain complaints occur in the patients and this causes many problems, especially mobility limitation. For this reason, a strong analgesic is needed. As a part of multimodal analgesia after total knee surgery, nerve blocks are frequently preferred. While central nerve blocks are preferred in the forefront, peripheral nerve blocks are frequently preferred due to complications related to central nerve blocks. Femoral nerve block and adductor channel block are the preferred peripheral blocks for total knee prosthesis. Since early mobilization after total hip prosthesis is very important, it is aimed to provide sufficient analgesia by making less motor block. Previous studies have shown that adductor channel block provides similar analgesia with femoral nerve block. Early mobilization, early discharge and the impact on the risk of falls are not yet clear, although it is estimated to be in the positive direction. Again, previous studies have compared single doses and infusion doses but no repeated bolus doses. Repeated bolus doses have been shown to be more effective in studies in which adductor channel catheters have been introduced to date to compare infusion and recurrent bolus doses. investigators aimed to compare the effects of repeated bolus doses with femoral nerve catheter and adductor channel catheter on postoperative pain and muscle strength in patients undergoing total knee replasment under spinal anesthesia in this study.

Conditions

Postoperative Pain; Functional Outcomes

Keywords

Postoperative Pain; Functional Outcomes; Total Knee Arthroplasty; Adductor Canal Block; Femoral Nerve Block

Outcome Measures

Primary Outcomes (1)

• Postoperative Muscle strength- Quadriceps Muscle strength scale

  Quadriceps Muscle strength scale

  postoperative 48 hour

Secondary Outcomes (1)

• postoperative analgesia - Visual analog scale

  72 hour

Study Arms (2)

femoral nerve block

ACTIVE COMPARATOR

Bupivacaine 0.25% will be applied to the catheter at 6 hours, when the first dose of catheter is inserted.

Procedure: femoral nerve block

adductor canal block

ACTIVE COMPARATOR

Bupivacaine 0.25% will be applied to the catheter at 6 hours, when the first dose of catheter is inserted.

Procedure: Adductor Canal Block

Interventions

Adductor Canal Block PROCEDURE

Adductor channel is roughly triangular in cross section and is bounded by three muscles: quadriceps anterolaterally (specifically vastusmedialis), sartorius medially and adductor magnus posteriorly. Within this canal is the femoral artery, femoral vein, the posterior branch of the obturator nerve, and branches of the femoral nerve; specifically the saphenous nerve and nerve to vastus medialis. When the femoral artery is shown by ultrasonography 21 gauge, 50 mm needle in-plane technique and the catheter will be inserted with the peripheral nerve stimulator lateral to the femoral artery. Bupivacaine 0.25% will be applied to the catheter at 6 hours, when the first dose of catheter is inserted.and the catheter will be inserted with the peripheral nerve stimulator lateral to the femoral artery. Bupivacaine 0.25% will be applied to the catheter at 6 hours, when the first dose of catheter is inserted.

Also known as: saphen nerve block

adductor canal block

femoral nerve block PROCEDURE

The probe is placed just below the inguinal crease , when the femoral artery is shown by ultrasonography, the femoral nerve stays in the lateral direction and 21 gauge, 50 mm needle will be advanced from the anterior to the posteriomedial with an in-plane technique and the catheter will be inserted by the peripheral nerve stimulator in the lateral femoral artery. Bupivacaine 0.25% will be applied to the catheter at 6 hours, when the first dose of catheter is inserted.

femoral nerve block

Eligibility Criteria

• Age: 55 Years - 85 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• ASA1-2-3 patients
• older than 55 years
• who undergo elective total knee prosthesis in our hospital

You may not qualify if:

• ASA IV patients ,
• patients with local anesthesia that we use,
• patients with coagulation disorders,
• patients with anatomical anomalies,
• patients with localized infection in the injection site ,
• patients who is incapable of using pca and/ or evaulate VAS scale,
• patients with peripheral nerve disease,
• patients with different surgical planning,
• complicated gonarthrosis patients,
• revision planned patients,
• patients who refuse to be involved in the study

Sponsors & Collaborators

• Kecioren Education and Training Hospital: lead

Study Sites (1)

SEDA

Ankara, Kecioren, 06380, Turkey (Türkiye)

Location

MeSH Terms

Conditions

Pain, Postoperative

Condition Hierarchy (Ancestors)

Postoperative Complications; Pathologic Processes; Pathological Conditions, Signs and Symptoms; Pain; Neurologic Manifestations; Signs and Symptoms

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: TRIPLE
• Who Masked: PARTICIPANT, INVESTIGATOR, OUTCOMES ASSESSOR
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: resident

Model Details: double blind, randomised, controlled train

Study Record Dates

• First Submitted: April 4, 2017
• First Posted: June 15, 2017
• Study Start: April 5, 2017
• Primary Completion: December 30, 2017
• Study Completion: December 31, 2017
• Last Updated: March 19, 2024

Record last verified: 2024-03

Locations

TU (1)