Adductor Canal Block for Total Knee Arthroplasty

• Status: Completed
• Trial end date: 2017-07-01
• Target enrollment: 0
• Participant gender: All

Summary

Total knee arthroplasty (TKA) can be associated with a large amount of postoperative pain. This pain can oftentimes be severe enough to limit participation in physical therapy and ultimately delay discharge resulting in increased cost. Several strategies have been developed in an effort to decrease postoperative pain following TKA while maintaining lower extremity strength and maximizing participation in physical therapy. Recently, adductor canal blockade has gained popularity as it is reported to provide analgesia to the anterior knee without resulting in significant quadriceps muscle weakness. However, few studies have carefully evaluated the impact of volume of injection of local anesthetic into the adductor canal on motor weakness or pain control. The ability to achieve similar pain control with decreased volumes of local anesthetic would allow the surgery team to apply more local anesthetic to posterior knee structures. Decreased volumes of local anesthetic may also be associated with a decreased risk of local anesthetic toxicity. This study aims to carefully evaluate this relationship using a physical therapy evaluation method that relies on both motor strength and pain control. In addition, the investigators hope to carefully evaluate motor strength using a novel method of strength measurement in an effort to further evaluate the impact of volume of injection of local anesthetic into the adductor canal on motor strength.

• Phase: N/A
• Accepts Healthy Volunteers?: No

Details

• Lead Sponsor: University of Wisconsin, Madison
• Treatments: Bupivacaine; Polystyrene sulfonic acid

Criteria

Inclusion Criteria:

1. The subject is scheduled for elective unilateral TKA

2. The subject is ≥ 18 years and ≤ 80 years;

3. The subject's weight is between 70-120 kg; and

4. The subject's primary anesthesia care team has planned for a neuraxial anesthetic (i.e. spinal, epidural or combined-spinal epidural).

5. The patient agrees to receive an adductor canal block.

6. American Society of Anesthesiologists class 1-3

Exclusion Criteria:

1. Subject is < 18 years of age or >80 years of age;

2. Subject is non-English speaking;

3. Subject is known or believed to be pregnant;

4. Subject is a prisoner;

5. Subject has impaired decision-making capacity; per discretion of the Investigator

6. Symptomatic untreated gastroesophageal reflux or otherwise at risk for perioperative aspiration;

7. Any condition for which the primary anesthesia care team deems neuraxial anesthesia inappropriate;

8. Significant pre-existing neuropathy on the operative limb;

9. Significant renal, cardiac or hepatic disease per discretion of the investigator.

10. American Society of Anesthesiologists class 4-5

11. Known hypersensitivity and/or allergies to local anesthetics

12. Chronic Opioid Use (daily or almost daily use of opioids for > 3 months)