Defining the Optimal Location to Place an Adductor Canal Block

NCT04298476 | Unknown DMC

• 1 other identifier: 1901006926
• Study Type: interventional
• Target: 80
• Locations: 1 country
• Sites: 1

Brief Summary

The aim of the current project is to address a gap in the existing literature related to optimal placement of local anesthetic for an adductor canal (AC) block. The current study seeks to examine whether placement of the local anesthetic in the AC for knee surgery is more effective at reducing post-operative pain following arthroscopic knee surgery compared to a control. Specifically, if the anesthetic is more beneficial than the control group, the research will determine which location is optimal by comparing groups that receive anesthetic in the midpoint of the thigh, the proximal end of the thigh, or the distal end of the thigh.

Conditions

Knee Arthropathy

Outcome Measures

Primary Outcomes (1)

• Reported pain as assessed by Wong-Baker FACES scale

  Patient self-reported pain intensity following the procedure. The scale ranges from 0-10 (0 = no pain; 10 = extreme). Collected at two points: pre-and-post procedure.

  48 hours

Secondary Outcomes (4)

• Patient reported anxiety as assessed by the Child's Anxiety Meter-State (CAM-S)

  48 hours

• Parent reported anxiety as assessed by the Child's Anxiety Meter-State (CAM-S

  48 hours

• Patient reported sensation through ice and pinprick

  48 hours

• Usage of narcotic pain medication

  48 hours

Study Arms (4)

A

PLACEBO COMPARATOR

Saline will be placed in syringe instead of ropivicaine 0.2% and the nerve block will be placed in the adductor canal at the desired location by the anesthesiologist

Procedure: Placement of an adductor canal nerve block

B

ACTIVE COMPARATOR

An adductor canal block will be placed with local anesthetic in the proximal 1/3 of the operative leg

Procedure: Placement of an adductor canal nerve block

C

ACTIVE COMPARATOR

An adductor canal block will be placed with local anesthetic in the middle 1/3 of the operative leg

Procedure: Placement of an adductor canal nerve block

D

ACTIVE COMPARATOR

An adductor canal block will be placed with local anesthetic in the distal 1/3 of the operative leg

Procedure: Placement of an adductor canal nerve block

Interventions

Placement of an adductor canal nerve block PROCEDURE

An adductor canal nerve block will be placed in a patient undergoing a knee arthroscopy in 1 of 3 locations with local anesthetic or placebo (without location definition or local anesthetic) to assess optimal placement of local anesthetic, pain management and anxiety scores post operatively.

A; B; C; D

Eligibility Criteria

• Age: 7 Years - 17 Years
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Child (0-17)

You may qualify if:

• Patient is 7 to ≤ 17 years of age
• Patient at St. Christopher's Hospital for Children
• Receiving a knee arthroscopy procedure
• English speaking

You may not qualify if:

• Patient is less than 7 years of age or over 17 years of age
• Patient has cognitive impairments
• Patient had previous operations on the same lower extremity as the current knee arthroscopy
• Patient has a positive B-HCG (identified through urine or blood test)
• Patient does not speak English

Sponsors & Collaborators

• Drexel University: lead

Study Sites (1)

St. Christopher's Hospital for Children

Philadelphia, Pennsylvania, 19103, United States

Location

Related Publications (6)

• Wong WY, Bjorn S, Strid JM, Borglum J, Bendtsen TF. Defining the Location of the Adductor Canal Using Ultrasound. Reg Anesth Pain Med. 2017 Mar/Apr;42(2):241-245. doi: 10.1097/AAP.0000000000000539.

  PMID: 28002228 BACKGROUND

• Bendtsen T.F., Lopez A.M., Clark T.B. (2018). Ultrasound-Guided Saphenous (Subsartorius/Adductor Canal) Nerve Block. NYSORA Continuing Medical Education. Retrieved from https://www.nysora.com/ultrasound-guided-saphenous-subsartoriusadductor-canal-nerve-block

  BACKGROUND

• Burckett-St Laurant D, Peng P, Giron Arango L, Niazi AU, Chan VW, Agur A, Perlas A. The Nerves of the Adductor Canal and the Innervation of the Knee: An Anatomic Study. Reg Anesth Pain Med. 2016 May-Jun;41(3):321-7. doi: 10.1097/AAP.0000000000000389.

  PMID: 27015545 BACKGROUND

• Quemby D. & McEwen A. (2014). Ultrasound Guided Adductor Canal Block (Saphenous Nerve Block). Anesthesia Tutorial of the Week. Retrieved from https://www.aagbi.org/sites/default/files/301%20Ultrasound%20Guided%20Adductor%20Canal%20(Saphenous%20Nerve)%20Block.pdf

  BACKGROUND

• Runge C, Moriggl B, Borglum J, Bendtsen TF. The Spread of Ultrasound-Guided Injectate From the Adductor Canal to the Genicular Branch of the Posterior Obturator Nerve and the Popliteal Plexus: A Cadaveric Study. Reg Anesth Pain Med. 2017 Nov/Dec;42(6):725-730. doi: 10.1097/AAP.0000000000000675.

  PMID: 28937534 BACKGROUND

• Ersig AL, Kleiber C, McCarthy AM, Hanrahan K. Validation of a clinically useful measure of children's state anxiety before medical procedures. J Spec Pediatr Nurs. 2013 Oct;18(4):311-9. doi: 10.1111/jspn.12042. Epub 2013 Jun 25.

  PMID: 24094126 BACKGROUND

Study Design

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

Study Record Dates

• First Submitted: February 18, 2020
• First Posted: March 6, 2020
• Study Start: March 1, 2020
• Primary Completion: December 31, 2020
• Study Completion: December 31, 2020
• Last Updated: March 6, 2020

Record last verified: 2020-03

Data Sharing

• IPD Sharing: Will not share

Locations

US (1)