Health TrialsbyHealthPanel

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

ConditionsAcute Postoperative PainSurgery
Trial statusRecruiting
Trial phasePhase 4
Trial typeInterventional
Biological sexAll
Age18+
SponsorUniversity of California, San Diego

About this trial

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.

Eligibility criteria

This trial does not accept healthy volunteers

Qualifiers

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)

Disqualifiers

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

Trial design

Design model

Parallel

Treatments tested in this trial

  • 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.

  • 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.

Treatment groups

40 Participants
are divided into 2 treatment groups
Group A: Continuous adductor canal blockExperimental treatment 1 intervention
Group B: single injection adductor canal blockActive comparator 1 intervention

Trial outcomes

Primary outcomes

1

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)

Time frame
7 days
2

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)

Time frame
7 days

Secondary outcomes

1

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

The physical and emotional functioning of research participants 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 with the Brief Pain Inventory Interference Subscale)

Time frame
7 days
2

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

Knee injury and osteoarthritis outcome score for joint replacement (KOOS JR)

Time frame
30 days
3

30-day pain score measured in Numeric Rating Scale

At around 30 days postoperatively, the patients average pain score measured in the numeric rating scale (0-10) will be assessed.

Time frame
30 days
4

30-day postoperative opioid consumption

Around 30 days postoperatively, the average opioid consumption will be assessed. This will be based on the average opioid consumption over the preceding week at 30 days.

Time frame
30 days

Other outcomes

Sponsors and contacts

Click on the lead sponsor to view all of their trials.

University of California, San Diego

Lead sponsor

Source ClinicalTrials.gov
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