Comparing Adductor Canal Block and Adductor Canal Block-Local Infiltration Analgesia for Post-operative Pain Management

NCT04721119 | Unknown DMC

• 1 other identifier: 2382
• Study Type: interventional
• Target: 100
• Locations: 0 countries
• Sites: N/A

Brief Summary

Anterior cruciate ligament (ACL) reconstruction is one of the most commonly performed surgeries amongst young orthopedic surgery patients. Optimal post-operative pain control helps to reduce the opioid burden and to improve the patient's experience. Regional anesthesia, such as the femoral nerve block (FNB) and adductor canal block (ACB), are commonly used for post-operative pain control after surgery. The ACB has replaced the FNB. This is because the ACB targets the femoral nerve, while avoiding the numbing effects on quadricep muscle strength that make it difficult to move the leg. Another form of pain control is local infiltration anesthesia (LIA), which directly blocks pain in the knee. Similar to the ACB, it avoids the numbing effects on the quadricep muscle.This can help improve patient safety and experience by reducing risks of falls and allowing the patient to move earlier. This can also be associated with decreased time in the hospital and decreased costs. Technically, it is less complex and can be done the shorter period of time. The purpose of this study is to refine the pain management technique following anterior cruciate ligament surgery. More specifically, the aim of this study is to evaluate the effects of LIA alone, and a LIA-ACB combination on post-operative pain and thigh muscle strength.

Conditions

ACL Tear; ACL; ACL Injury

Outcome Measures

Primary Outcomes (2)

• Oral morphine equivalent consumption

  Cumulative oral morphine equivalent consumption over 24 hours post-op

  Up to 24-hours after surgery

• Quadriceps motor strength

  Percent decrease in quadriceps motor strength at 30 minutes following anesthesia compared to baseline

  Pre-op, 30 minutes post-anesthesia

Secondary Outcomes (6)

• inta-operative opioid consumption

  during surgery

• Oral morphine equivalent consumption in PACU

  PACU admission to PACU discharge (approximately 4 hours)

• Post-operative Pain

  Up to 24 hours post-operative

• Quality of Recovery

  At 24 hours post-operative

• Time in hospital

  From hospital admission to hospital discharge (approximately 12 hours)

Study Arms (2)

Local Infiltration Anesthetic

EXPERIMENTAL

This group of patients will receive the local infiltration anesthetic only.

Procedure: Local Infiltration Anesthetic

Local Infiltration Anesthetic + Adductor Canal Block

EXPERIMENTAL

This group of patients will receive the local infiltration anesthetic and adductor canal block combination.

Procedure: Local Infiltration Anesthetic + Adductor Canal Block

Interventions

Local Infiltration Anesthetic PROCEDURE

For the local infiltration anesthetic, patients will receive 20 cc of 0.5% ropivacaine, by intra-articular injection performed by the surgeon. The injection is done at the end of the surgical procedure, after suturing the incision.

Local Infiltration Anesthetic

Local Infiltration Anesthetic + Adductor Canal Block PROCEDURE

For the local infiltration anesthetic, patients will receive 20 cc of 0.25% ropivacaine, by intra-articular injection performed by the surgeon. The injection is done at the end of the surgical procedure, after suturing the incision. For the adductor canal block, patients will receive 20 cc of 0.25% ropivicaine, through injection performed by the anesthesiologist. The injection is done under the sartorius muscle, in mid-thigh, using ultrasound guidance.

Local Infiltration Anesthetic + Adductor Canal Block

Eligibility Criteria

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

You may qualify if:

• English speaking or any other language with possibility of adequate translation
• ASA I-III patients
• Age 18-50
• BMI ≤ 38 kg/m2

You may not qualify if:

• Refusal or inability to provide informed consent
• Any contraindication to regional anesthesia including coagulopathy or bleeding diathesis,
• Allergy to local anesthetics, or infection at the site of the block
• History of long-term opioid intake (more than 3 months use) or chronic pain disorder (more than 3 months)
• History of preexisting neuropathy in the operative leg
• Revision of ACL repair

Sponsors & Collaborators

• Ottawa Hospital Research Institute: lead

MeSH Terms

Conditions

Anterior Cruciate Ligament Injuries

Condition Hierarchy (Ancestors)

Knee Injuries; Leg Injuries; Wounds and Injuries

Central Study Contacts

Meaghan Dufresne

CONTACT

613-737-8899; meadufresne@ohri.ca

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: August 19, 2020
• First Posted: January 22, 2021
• Study Start: February 1, 2021
• Primary Completion: August 1, 2021
• Study Completion: November 1, 2021
• Last Updated: January 22, 2021

Record last verified: 2021-01