Knee Arthroscopy for Pain Control

NCT06701175 | Withdrawn

• 2 other identifiers: IRB-300013299UAB
• Study Type: interventional
• Target: N/A
• Locations: 0 countries
• Sites: N/A

Brief Summary

This study aims to determine the effectiveness of an anterolateral genicular nerve block and portal anesthesia in controlling pain in the perioperative period after knee arthroscopy. Opioid consumption, the use of non-opioid medications, complication rate, and sleep quality will also be measured.

Conditions

Knee Arthroscopy

Outcome Measures

Primary Outcomes (1)

• Postoperative Pain Management

  Collected variables will include average and worst pain (0-10 scale, higher values representing increased pain), dose frequency of prescribed opioid analgesics, consumption of prescribed nonopioid analgesics, the longest period of uninterrupted sleep (in hours; only obtained at 12 and 24 hours and 1 week), and the subjective quality of sleep (0-10 scale, higher values representing better sleep), and overall satisfaction with pain control (five-point Likert scale, higher values representing increased satisfaction). A Visual Analog Score will be used in the evaluation of pain.

  2, 4, 6, 12, 24, and 48 hours and 1 week post-op

Study Arms (3)

No Intervention

NO INTERVENTION

Patients will receive no intervention

Nerve Block

ACTIVE COMPARATOR

Patients in the anterolateral geniculate nerve block group will receive 20 cc of 0.25% bupivacaine with epinephrine distributed evenly between two injection sites by an 18G or 21G long needle. After completion of knee arthroscopy, the first injection is targeted at 2 fingerbreadths superior to the superolateral aspect of the patella. The needle is inserted down to the femur, pulled back slightly, and the surrounding area is infiltrated with 10 cc of anesthetic. The second injection is targeted approximately 2 to 3 fingerbreadths laterally to the first injection and 2 to 3 fingerbreadths proximal to the lateral epicondyle in line with the lateral femur. Once again, the needle is inserted down until bone is encountered and then slightly retracted 1 to 2 mm before infiltration with the remaining 10 cc of anesthetic.

Procedure: Nerve Block

Portal Anesthesia

ACTIVE COMPARATOR

Patients in the portal anesthesia group will also receive 20 cc of 0.25% bupivacaine with epinephrine distributed evenly between portal sites. After completion of knee arthroscopy, portal tracts are closed and the knee is ensured to be evacuated of residual fluid. An 18G or 21G long needle is then used to infiltrate each portal tract where the anesthetic will be delivered.

Procedure: Portal Anesthesia

Interventions

Nerve Block PROCEDURE

anterolateral geniculate nerve block

Nerve Block

Portal Anesthesia PROCEDURE

portal anesthesia

Portal Anesthesia

Eligibility Criteria

• Age: 19 Years - 89 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• skeletally mature patients with indications for knee arthroscopy

You may not qualify if:

• include patients with previous knee surgery on the operative side
• opioid use within six weeks before surgery that is deemed to be chronic or excessive
• gabapentin use within six weeks before surgery
• diagnosis of chronic pain, fibromyalgia, or other somatosensory disorder(s)
• history of radicular pain or neuropathy in the operative limb
• patients with cancer

Sponsors & Collaborators

• University of Alabama at Birmingham: lead

Related Publications (7)

• Townshend D, Emmerson K, Jones S, Partington P, Muller S. Intra-articular injection versus portal infiltration of 0.5% bupivacaine following arthroscopy of the knee: a prospective, randomised double-blinded trial. J Bone Joint Surg Br. 2009 May;91(5):601-3. doi: 10.1302/0301-620X.91B5.21932.

  PMID: 19407292 BACKGROUND

• Ghodki PS, Shalu PS, Sardesai SP. Ultrasound-guided adductor canal block versus femoral nerve block for arthroscopic anterior cruciate ligament repair under general anesthesia. J Anaesthesiol Clin Pharmacol. 2018 Apr-Jun;34(2):242-246. doi: 10.4103/joacp.JOACP_172_17.

  PMID: 30104837 BACKGROUND

• Howell R, Hill B, Hoffman C, Treacy E, Mulcahey MK. Peripheral Nerve Blocks for Surgery About the Knee. JBJS Rev. 2016 Dec 6;4(12):e1. doi: 10.2106/JBJS.RVW.16.00003.

  PMID: 28060787 BACKGROUND

• Tyler TF, McHugh MP, Gleim GW, Nicholas SJ. The effect of immediate weightbearing after anterior cruciate ligament reconstruction. Clin Orthop Relat Res. 1998 Dec;(357):141-8. doi: 10.1097/00003086-199812000-00019.

  PMID: 9917711 BACKGROUND

• Chunduri A, Aggarwal AK. Multimodal Pain Management in Orthopedic Surgery. J Clin Med. 2022 Oct 28;11(21):6386. doi: 10.3390/jcm11216386.

  PMID: 36362617 BACKGROUND

• Paul RW, Szukics PF, Brutico J, Tjoumakaris FP, Freedman KB. Postoperative Multimodal Pain Management and Opioid Consumption in Arthroscopy Clinical Trials: A Systematic Review. Arthrosc Sports Med Rehabil. 2021 Dec 17;4(2):e721-e746. doi: 10.1016/j.asmr.2021.09.011. eCollection 2022 Apr.

  PMID: 35494281 BACKGROUND

• Meissner W, Mescha S, Rothaug J, Zwacka S, Goettermann A, Ulrich K, Schleppers A. Quality improvement in postoperative pain management: results from the QUIPS project. Dtsch Arztebl Int. 2008 Dec;105(50):865-70. doi: 10.3238/arztebl.2008.0865. Epub 2008 Dec 12.

  PMID: 19561807 BACKGROUND

MeSH Terms

Interventions

Nerve Block

Intervention Hierarchy (Ancestors)

Anesthesia, Conduction; Anesthesia; Anesthesia and Analgesia; Denervation; Neurosurgical Procedures; Surgical Procedures, Operative

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: NONE
• Purpose: TREATMENT
• Intervention Model: SINGLE GROUP
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Assistant Professor

Model Details: Patients indicated for knee arthroscopy

Study Record Dates

• First Submitted: November 11, 2024
• First Posted: November 22, 2024
• Study Start: December 1, 2025
• Primary Completion (Estimated): August 1, 2026
• Study Completion (Estimated): October 1, 2026
• Last Updated: January 9, 2026

Record last verified: 2026-01

Data Sharing

• IPD Sharing: Will not share