Comparison of Genicular Nerve Block and Intraarticular Injection for Postoperative Pain in Knee Arthroscopy

NCT04656743 | Completed DMC

• 1 other identifier: pain in knee arthroscopy
• Study Type: interventional
• Target: 66
• Locations: 1 country
• Sites: 1

Brief Summary

This prospective double-blinded randomized study will be conducted to compare ultrasound-guided intra-articular injection and ultrasound-guided genicular nerve block for postoperative analgesia after knee arthroscopy.

Conditions

Postoperative Pain

Outcome Measures

Primary Outcomes (1)

• first time of rescue analgesia

  first time of rescue morphine analgesia

  postoperative first day

Secondary Outcomes (2)

• Number of patients received rescue analgesia.

  postoperative first day

• Total doses of postoperative morphine consumption

  postoperative first day

Study Arms (2)

intra-articular injection group

EXPERIMENTAL

will receive ultrasound guided intraarticular injection consisting of 20 mL of 0.25% bupivacaine before surgical procedure. The surgical procedure will be started 30 min after intraarticular injection.

Procedure: intra-articular injection

genicular nerve block group

EXPERIMENTAL

will receive ultrasound guided genicular nerve block at three nerves, i.e., superomedial, superolateral, and inferomedial genicular nerves consisting of 15 ml bupivacaine 0.25% before surgical procedure. The surgical procedure will be started 30 min after genicular nerve block.

Procedure: genicular nerve block

Interventions

intra-articular injection PROCEDURE

The injection will be performed under ultrasound guidance by placing the patient's knee in approximately 90° of flexion with the leg hanging off the side of the bed (left). A high-frequency linear transducer ultrasound probe is placed in the superolateral corner of the patella, directed medially toward the patellofemoral joint space. In the extended leg, from anterior to posterior, the right image shows the quadriceps femoris tendon (QF), suprapatellar fat pad (SF), suprapatellar bursa (SB), prefemoral fat pad (PF), and femur (F). When the knee is flexed to 90°, the size of the suprapatellar bursa image is increased. Using an in-plane approach, the needle will be directed into the suprapatellar joint space, and 20 ml of bupivacaine 0.25% will be injected.

intra-articular injection group

genicular nerve block PROCEDURE

The transducer will be first placed parallel to the long bone shaft and moved up or down to identify the epicondyle of the long bone. The genicular arteries will be identified near the periosteal areas, confirmed by color Doppler ultrasound. Accordingly, genicular nerve block target points should be next to each genicular artery. After using color Doppler to confirm the genicular artery, the needle will be inserted in the plane of the ultrasound probe in the long-axis view. a gentle aspiration will be performed and a 2 mL injection volume will be administered.

genicular nerve block group

Eligibility Criteria

• Age: 18 Years - 50 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64)

You may qualify if:

• scheduled for unilateral knee arthroscopy surgery (ligament reconstruction, cartilage procedures, and diagnostic arthroscopic procedures)
• aged between 18 and 50 years
• of both genders,
• have ASA physical status I and II.

You may not qualify if:

• Revision knee arthroscopy,
• previous surgery or trauma to the knee,
• drug allergy,
• regular narcotic use,
• renal \&/ or hepatic impairments,
• neuromuscular diseases
• and coagulopathy disorders.

Sponsors & Collaborators

• Tanta University: lead

Study Sites (1)

Tarek Abdel Hay

Tanta, El Gharbyia, 31527, Egypt

Location

MeSH Terms

Conditions

Pain, Postoperative

Interventions

Injections, Intra-Articular

Condition Hierarchy (Ancestors)

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

Intervention Hierarchy (Ancestors)

Injections; Drug Administration Routes; Drug Therapy; Therapeutics

Study Design

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

Study Record Dates

• First Submitted: November 30, 2020
• First Posted: December 7, 2020
• Study Start: December 10, 2020
• Primary Completion: March 1, 2024
• Study Completion: April 15, 2024
• Last Updated: May 1, 2024

Record last verified: 2024-04

Locations

EG (1)