The Efficacy of Continuous Femoral Nerve Catheter Orifice Configuration for Postoperative Analgesia in Knee Arthroplasty
Condition: Anesthesia; Catheter Blockage; Knee Arthropathy; Pain, Postoperative
MeSH terms: Pain, Postoperative
Study type: Interventional

Summary: 
      Femoral nerve catheter for postoperative analgesia will be included in the adult patients
      undergoing total knee arthroplasty included in the study. These patients will be randomized
      to the catheter tip configuration as CEMP (closed-ended multiport catheter) group and OESP
      (open-ended single port catheter) group. Patient controlled analgesia device will be attached
      to the peripheral nerve catheter of these patients. Demographic data of the patients , the
      number of pushing the button the amount of bolus dose given, and the total dose given in the
      patient controlled anesthesia device, the need for additional analgesia and the amount, pain
      scores, complications will be recorded for three days postoperatively. Records will be
      compared statistically.
    

Detailed description: 
      Ethics committee approval was received on 10 December 2019, numbered 19/397. The study was
      planned to include 90 adult patients undergoing total knee arthroplasty at Gülhane Training
      and Research Hospital between 10 December 2019 and April 2020. Continue femoral nerve
      catheter for postoperative analgesia will be included in the patients included in the study.
      These patients will be randomized to the catheter tip configuration as CEMP (closed-ended
      multiport catheter) group and OESP (open-ended single port catheter) group. Patient
      controlled analgesia device will be attached to the peripheral nerve catheter of these
      patients. Demographic data of the patients who have placed an femoral nerve catheter and used
      the catheter successfully for three days postoperatively, the number of pushing the button,
      the amount of bolus dose given and the total dose given in the patient controlled anesthesia
      device,the amounts of need for additional analgesia and pain scores(Numeric rating Scale),
      complications will be recorded for three days postoperatively. Records will be compared
      statistically.
    

Intervention name(s): CEMP (closed-ended multiport catheter) group; OESP (open-ended single port catheter) group
Intervention type(s): Procedure; Procedure
Intervention description(s): After sterile preparation and large inguinal crease draping, with the US probe in a sterile sleeve or cover , we will proceed to hydrolocalization with 5-10 mL 5% dextrose in order to open the space between the femoral nerve and the superior part of the ilio-psoas muscle. The Contiplex® FX Non-Stimulating Tuohy Set, 17Ga. x 3½ inches. the Non-Stimulating Needle and the closed-tip multiport catheter will be then inserted under control and its position assessed between the femoral nerve and the superior aspect of the ilio-psoas muscle. Some aliquots of 5% dextrose will inject to confirm correct dispersal of the solution along the femoral nerve. The catheter will be tunnelled subcutaneously.A patient-controlled analgesic device will be attached to the catheter for postoperative analgesia. continuous peripheral nerve patient-controlled analgesia is as follows: 0.125% bupivacaine; hourly infusion: 4 ml / hour, pca dose (bolus): 5 ml / hour, lock-up time: 30 min, 4-hours limit: 30 ml.; After sterile preparation and large inguinal crease draping, with the US probe in a sterile sleeve or cover , we will proceed to hydrolocalization with 5-10 mL 5% dextrose in order to open the space between the femoral nerve and the superior part of the ilio-psoas muscle. The Contiplex® FX Non-Stimulating Tuohy Set, 17Ga. x 3½ inches. the Non-Stimulating Needle and the open-ended catheter will be then inserted under control and its position assessed between the femoral nerve and the superior aspect of the ilio-psoas muscle. Some aliquots of 5% dextrose will inject to confirm correct dispersal of the solution along the femoral nerve. The catheter will be tunnelled subcutaneously. A patient-controlled analgesic device will be attached to the catheter for postoperative analgesia. continuous peripheral nerve patient-controlled analgesia is as follows: 0.125% bupivacaine; hourly infusion: 4 ml / hour, pca dose (bolus): 5 ml / hour, lock-up time: 30 min, 4-hours limit: 30 ml.
Allocation: Randomized
Intervention model: Parallel Assignment
Intervention model description: The patients will be randomized to the catheter tip configuration as CEMP (closed-ended multiport catheter) group and OESP (open-ended single port catheter) group
Masking: None (Open Label)
Primary purpose: Treatment
Keywords: femoral nerve catheter; Total Knee Arthroplasty; Catheter tips configurations; continuous nerve block