Continuous Adductor Canal Block in Fast Track Total Knee Arthroplasty
Status:
Recruiting
Trial end date:
2024-12-31
Target enrollment:
Participant gender:
Summary
Total knee arthroplasty (TKA) is a frequent performed surgery. Many institutions are
implementing fast track programs for this surgery and adequate pain management is an
important feature. Analgesic duration of single shot nerve blocks is limited to no more than
24h. Conversely, the use of continuous nerve block (CNB) through a perineural catheter and
infusion of local anesthetic may increase duration of analgesia and provide better outcomes.
The purpose of this study is to evaluate effectiveness and safety of using CNB in patients
undergoing ambulatory TKA, and its effects on patients' quality of recovery. Investigators
hypothesize that continuous adductor canal block would lead to decrease in opioid consumption
in patients undergoing fast track TKA.
Significance There are no published prospective randomized controlled trials to assess
patient's reported quality of recovery after receiving CACB in same day primary knee
arthroplasties. As this is a frequent type of surgery and has the prediction to increase its
incidence for the next years, there is significant importance in investigations about
interventions which may improve its recovery in a fast track regime. A postoperative
analgesic technique that offers better pain control, has less adverse effects, reduces the
opioid analgesia requirement and is safe to be used in a fast track setting may have
additional impact on decreasing health care cost and may lead to an enhanced recovery and
better quality of life.
Objectives To evaluate effectiveness and safety of using CACB in patients undergoing
ambulatory TKA, in comparison to SACB. Primary objective is opioid consumption (in oral
morphine equivalent doses) Secondary objectives are to evaluate postoperative QoR-15 scores
(10), pain scores, opioid-induced adverse effects (measured via validated opioid symptom
distress scale), postoperative functional status, complications relating to the perineural
catheter and readmissions.
Phase:
N/A
Details
Lead Sponsor:
Samuel Lunenfeld Research Institute, Mount Sinai Hospital