Continuous Versus Single Injection Adductor Canal Blocks for Outpatient Total Knee Arthroplasty

NCT06784882 | Recruiting Phase 4 FDA Device

• 1 other identifier: 811228
• Study Type: interventional
• Target: 40
• Locations: 1 country
• Sites: 1

Brief Summary

This is a single-center pilot study to determine if an adductor canal continuous nerve block is superior to single injection nerve block following total knee arthroplasty. Investigators will randomize participants to either continuous nerve block or single injection nerve block for the adductor canal preoperatively. They will assess differences in pain (measured in numeric rating scale), opioid consumption, and physical therapy milestones from postoperative day 0 to 7.

Conditions

Acute Postoperative Pain; Surgery

Keywords

regional anesthesia; total knee arthroplasty; nerve block

Outcome Measures

Primary Outcomes (2)

• analgesic effect of 5-day continuous nerve block of the adductor canal relative to a single inection nerve block with ropivacaine.

  Numeric Rating Scale (NRS) for pain will be superior daily with continuous adductor canal blocks on postoperative days 1-7 following total ankle arthroplasty as compared with single-injection adductor canal blocks (as measured by the "average" daily NRS within the Brief Pain Inventory)

  7 days

• opioid consumption of 5-day continuous nerve block of the adductor canal relative to a single inection nerve block with ropivacaine.

  Opioid consumption will be superior daily with continuous adductor canal blocks on postoperative days 1-7 following total ankle arthroplasty as compared with single-injection adductor canal blocks (measured in oxycodone equivalents)

  7 days

Secondary Outcomes (4)

• physical and emotional functioning of 5-day continuous nerve blocks relative to a single injection nerve blocks with ropivacaine

  7 days

• improvement in physical therapy milestones of 5-day continuous nerve blocks relative to a single injection nerve blocks with ropivacaine

  30 days

• 30-day pain score measured in Numeric Rating Scale

  30 days

• 30-day postoperative opioid consumption

  30 days

Study Arms (2)

Continuous adductor canal block

EXPERIMENTAL

single injection with ropivacaine (0.5%) of the adductor canal block and a 5-day continuous perineural infusion of ropivacaine (0.2%) (experimental group)

Device: continuous peripheral nerve block with OnQ pump

single injection adductor canal block

ACTIVE COMPARATOR

single injection with ropivacaine (0.5%) of the adductor canal block and no continuous nerve block added

Drug: single injection nerve block

Interventions

continuous peripheral nerve block with OnQ pump DEVICE

For continuous nerve blocks, the infusion pump that will be used are OnQ pumps (Avanos, Alpharetta, GA) and pre-filled with ropivacaine 0.2% and provided by UCSD's Investigational Drug Services.

Continuous adductor canal block

single injection nerve block DRUG

An adductor canal single injection nerve block will be performed per standard of care. The adductor canal will be identified by ultrasound in the short-axis view. The distal aspect of the femoral triangle (and beginning of the adductor canal) will be identified distal to the mid-thigh in the ipsilateral limb. Using ultrasound guidance, a standard Tuohy block needle will be advanced through a skin wheal of lidocaine until its tip is in the hypoechoic area immediately distal saphenous nerve adjacent to the femoral artery. Twenty milliliters of ropivacaine 0.5% will be injected in divided doses with repeated negative aspiration.

single injection adductor canal block

Eligibility Criteria

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

You may qualify if:

• Adult participants of at least 18 years of age
• Undergoing a primary, unilateral, total knee arthroplasty
• Planned single-injection adductor canal nerve block
• Weight \> 50 kg (to minimize the risk of local anesthetic toxicity)

You may not qualify if:

• chronic opioid or tramadol use: daily oxycodone equivalents \> 20 mg for \> 4 weeks
• neuro-muscular deficit of the surgical limb
• moderate pain (NRS \> 3) in an anatomic location other than the surgical site
• planned hospital admission following surgery
• history of opioid misuse
• those who lack capacity to complete informed consent
• inability to contact the investigators during the treatment period, and vice versa (e.g., lack of telephone access)
• incarceration
• pregnancy
• allergy to amide local anesthetics

Sponsors & Collaborators

• University of California, San Diego: lead

Study Sites (1)

University of California, San Diego

La Jolla, California, 92037, United States

RECRUITING

Related Publications (1)

• Chou R, Gordon DB, de Leon-Casasola OA, Rosenberg JM, Bickler S, Brennan T, Carter T, Cassidy CL, Chittenden EH, Degenhardt E, Griffith S, Manworren R, McCarberg B, Montgomery R, Murphy J, Perkal MF, Suresh S, Sluka K, Strassels S, Thirlby R, Viscusi E, Walco GA, Warner L, Weisman SJ, Wu CL. Management of Postoperative Pain: A Clinical Practice Guideline From the American Pain Society, the American Society of Regional Anesthesia and Pain Medicine, and the American Society of Anesthesiologists' Committee on Regional Anesthesia, Executive Committee, and Administrative Council. J Pain. 2016 Feb;17(2):131-57. doi: 10.1016/j.jpain.2015.12.008.

  PMID: 26827847 BACKGROUND

MeSH Terms

Conditions

Pain, Postoperative

Condition Hierarchy (Ancestors)

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

Central Study Contacts

Rodney A Gabriel, MD

CONTACT

858-663-7747; ragabriel@health.ucsd.edu

Study Design

• Study Type: interventional
• Phase: phase 4
• Allocation: RANDOMIZED
• Masking: NONE
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Associate Professor

Study Record Dates

• First Submitted: January 11, 2025
• First Posted: January 20, 2025
• Study Start: June 1, 2025
• Primary Completion: December 1, 2025
• Study Completion: December 1, 2025
• Last Updated: June 17, 2025

Record last verified: 2025-06

Locations

US (1)