Tow Techniques of Adductor Canal Block for Analgesia After Total Knee Replacement

Study Overview
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Brief Summary
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This study compares the tow technique of continues adductor canal block for total knee replacement surgery. Half participants will receive catheterization at the entrance of the adductor canal, while the other half will receive catheterization at the middle point of the adductor canal.

Official Title
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Ultrasound-guided Continuous Adductor Canal Block for Analgesia After Total Knee Replacement: Comparison of Block at the Entrance and Middle of the Canal

Conditions
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Total Knee Arthroplasty, Analgesia, Nerve Block

Intervention / Treatment
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* Procedure: ultrasound-guided short-axis placement of catheter at the entrance of the adductor canal
* Procedure: ultrasound-guided long-axis placement of catheter at the middle of the adductor canal


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: 18-80 years Knee-arthroscopy Written consent ASA I-III BMI 19-35 Exclusion Criteria: Unable to communicate with the investigators (e.g., a language barrier or a neuropsychiatric disorder). coagulopathy or on anticoagulant medication Allergic reactions toward drugs used in the trial History of substance abuse Infection at injection site Can not be mobilised to 5 meters of walk pre-surgery

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 80 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Supportive Care
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Triple


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: entrance placement of adductor canal catheter<br> | Procedure: ultrasound-guided short-axis placement of catheter at the entrance of the adductor canal<br>* Ultrasound probe is placed at the entrance of the adductor canal in short axis ，insertion of a PAJUNK Contiplex S catheter with the tip of the catheter located at the entrance of the canal<br>|
| Experimental: middle point placement of adductor canal catheter<br> | Procedure: ultrasound-guided long-axis placement of catheter at the middle of the adductor canal<br>* Ultrasound probe is placed at the middle of the adductor canal in long axis with the caphelad end of the probe aligned with the entrance of the canal. insertion of a PAJUNK Contiplex S catheter with the tip of the catheter located at the middle of the canal<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| cumulative sulfentanil consumption at 24 hours after surgery |  | 24 hours after surgery | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| the strength of quadriceps femoris | Quadriceps strength was assessed on a 0-5 scale as per the Medical Research Council Scale quadriceps motor strength(0 = no voluntary contraction possible, 1 = muscle flicker, but no movement of limb, 2 = active movement only with gravity eliminated, 3 = movement against gravity but without resistance, 4 = movement possible against some resistance and 5 = normal motor strength against resistance) | 0,2,4,8,24,48 hours postoperatively | 
| The pain scores at rest determined by the numeric rating scale (NRS, 0-10) | 11-point numerical rating scale (NRS; 0, no pain; 10, maximum pain imaginable). | at 0,2,4,8,24,48 hours postoperatively | 
| The pain scores on adduction of the keen determined by the numeric rating scale (NRS, 0-10) | 11-point numerical rating scale (NRS; 0, no pain; 10, maximum pain imaginable). | at 0,2,4,8,24,48 hours postoperatively | 
| incidence of postoperative nausea and vomiting (PONV) |  | within 48 hours after surgery | 
| Patient satisfaction with anesthesia | Patient satisfaction with anesthesia was assessed using a 5-point scale (5, very satisfied; 4, satisfied; 3, neither satisfied nor dissatisfied; 2, dissatisfied; 1, very dissatisfied) | within 5th day after surgery | 
| complications | Record complications including catheter dislodgment, puncture point infection, leakage,falling down,et al. | within 3days after surgery | 
| cumulative sulfentanil consumption at other time points after surgery |  | 2,4,8,48 hours postoperatively | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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adductor canal block