Please select the eligibility criteria that correspond to the clinical trial below.
Title: Continuous Adductor Canal Block With Epidural Analgesia for Total Knee Arthroplasty: A Prospective, Randomized, Double-blinded, Placebo-Controlled Trial
Brief Summary: The purpose of this study is to further investigate the efficacy of adductor canal nerve blocks for pain management after total knee replacement. Specifically we are studying adductor canal nerve blocks in conjunction with epidural anesthesia, which is a combination that has not been extensively researched before. Our question is whether combining these modalities will enhance patient satisfaction after surgery and accelerate patients' readiness to discharge.


Options:
A: Inclusion Criteria:

* end stage degenerative joint disease
* enrolled for unilateral total knee arthroplasty at the University of Chicago
* age \< 85
* ability to understand and willingness to sign a written informed consent

Exclusion Criteria:

* age \> 85
* American Society of Anesthesiologists physical status \> 3
* known hypersensitivity to lidocaine, bupivacaine, ropivacaine or other local anesthetic agents
* Coagulopathy, specifically INR \> 1.5, Platelets \< 100, therapy with clopidogrel within 5 days prior to surgery, enoxaparin or fondaparinux within the last 24 hours prior to surgery, patients with anti-phospholipid syndrome requiring aggressive anticoagulation perioperatively
* History of alcohol or substance abuse (including strong opioids - morphine, oxycodone, methadone, fentanyl, ketobemidone), taking \> 50 mg morphine equivalent daily of opioids
* Pre-existing femoral neuropathy or radiculopathy
* Patients with poor ability to communicate
B: Inclusion Criteria:

* ASA I-III
* Age: 40-75
* Unilateral TKA
* Use of Spinal anesthesia

Exclusion Criteria:

* Allergy to any of the study medications
* Intolerance to morphine
* Contraindication to a spinal anesthetic
* Intraoperative use of any volatile anesthetic
* Chronic opioid use
* ASA Class 4-5
* Rheumatoid arthritis or Diabetes mellitus with neuropathy
* Liver or kidney failure
* BMI above 40
* Severe COPD
C: Inclusion Criteria:

1. undergoing surgery with an adductor canal or popliteal-sciatic perineural catheter for postoperative analgesia following primary tri-compartment knee arthroplasty or foot/ankle surgery;
2. anticipated to have at least moderate pain following surgery \[NRS\>3\]; and,
3. age 18 years or older.

Exclusion Criteria:

1. pregnancy (a urine pregnancy test is standard at UCSD for female patients prior to menopause who are sexually active with the opposite sex within the previous year);
2. inability to communicate with the investigators and hospital staff;
3. clinical neuropathy in the surgical extremity;
4. chronic high-dose opioid use (defined as daily use for more than 4 weeks prior to surgery of at least the equivalent of 20 mg oxycodone);
5. BMI \> 40 kg/m2;
6. allergy to study medications (lidocaine, ropivicaine);
7. known renal insufficiency; or,
8. incarceration.
D: Inclusion Criteria:

* American Society of Anesthesiologists Physical Status I-III
* 18 - 80 years of age
* BMI 18 - 40
* Scheduled for elective total knee replacement under spinal anesthesia
* Able to ambulate independently with a standard wheeled walker as maximum mobility aid

Exclusion Criteria:

* Revision knee arthroplasty
* Bilateral knee arthroplasty
* Lack of mental ability to provide informed consent
* Neuropathic pain or sensory disorders of the surgical limb
* Contraindication to regional anesthesia (intolerance to the study drugs, bleeding diathesis, coagulopathy, malignancy or infection at the site of block)
* Chronic opioid use defined as \> 30 mg of daily oral morphine equivalents

Answer: A