Comparison of Two Multimodal Analgesia Regimens in Total Knee Arthroplasty
Status:
Terminated
Trial end date:
2019-10-01
Target enrollment:
Participant gender:
Summary
The improvement of postoperative analgesia is an important issue in orthopedic surgery,
especially after total knee arthroplasty The use of a peripheral nerve block such as the
adductor canal block is favored since it offers a postoperative analgesia superior to
opioids, and also preserves the strength of the quadriceps, as opposed to the femoral block.
The adductor canal block can be given as a single injection (single shot) or a continuous
perineural infusion to extend the block's analgesic duration. It is unclear if the continuous
infusion is superior to the single shot. Indeed, a high catheter dislodgement rate is
observed for this location and local anesthetics could migrate into the femoral canal,
resulting in quadriceps weakness. Alternatively, adequate postoperative analgesia has been
shown effective with a single shot adductor canal block combined with extended release
opioids.
The primary objective in this study is to compare two analgesic protocols on the pain score
at walk 24 hours after total knee arthroplasty.
Here are the two protocols compared :
1. Adductor canal block followed by continuous perineural perfusion for 48 hours
2. Adductor canal block (single shot) followed by hydromorphone extended release
formulation for 48 hours In addition to analgesic adjuvants administered in both groups
: acetaminophen, celecoxib, pregabalin, dexamethasone and periarticular infiltration.
Our hypothesis is that both protocols ensure a similar analgesia.