Regional Anesthesia for Knee Prothesis Surgery

Study Overview
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Brief Summary
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Comparison of the analgesics blocks (femoral, adductor canal and sciatic subgluteal nerve) for total replacement knee surgery.

Detailed Description
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Adductor canal block shows a beneficial effect for knee surgery. Mainly because he prevent for muscular weakness; adverse effect meet with femoral block and delaying the early active mobilization. The investigators want to compare the efficacy and safety of this block compared to the femoral and sciatic block.

Official Title
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Regional Blockade for Knee Prothesis Surgery: Comparison Between Femoral, Sciatic and Adductor Canal Block

Conditions
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Total Knee Replacement

Intervention / Treatment
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* Drug: Analgesic nerve blockade (Ropivacaine)
* Procedure: Total knee replacement surgery.


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: patients scheduled for total knee replacement surgery. Exclusion Criteria: refusal to study, coagulation disorder, infection at the puncture site, preexisting neuropathy, allergy to local anesthetics, renal or hepatocellular insufficiency, context of chronic pain, drugs abuse, pregnant patient.

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 75 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Active Comparator: Femoral nerve blockade<br>In this group, patient will benefit of an ultrasound guided femoral nerve blockade with continuous catheter infusion as (initial bolus of 20ml of ropivacaine 0.75% follow with 7ml/hour of ropivacaine 0.2%) as analgesic nerve blockade for total knee replacement surgery. | Drug: Analgesic nerve blockade (Ropivacaine)<br>* Analgesic nerve blockade (Ropivacaine) for total knee replacement surgery.<br>* Other names: Regional anesthesia;Procedure: Total knee replacement surgery.<br>* Total knee replacement surgery.<br>|
| Active Comparator: Adductor canal blockade<br>In this group, patient will benefit of an ultrasound guided adductor canal blockade with continuous catheter infusion (initial bolus of 20ml of ropivacaine 0.75% follow with 7ml/hour of ropivacaine 0.2%) as analgesic nerve blockade for for total knee replacement surgery. | Drug: Analgesic nerve blockade (Ropivacaine)<br>* Analgesic nerve blockade (Ropivacaine) for total knee replacement surgery.<br>* Other names: Regional anesthesia;Procedure: Total knee replacement surgery.<br>* Total knee replacement surgery.<br>|
| Active Comparator: Subgluteal sciatic nerve blockade<br>In this group, patient will benefit of an ultrasound guided subgluteal sciatic nerve blockade with continuous catheter infusion (initial bolus of 20ml of ropivacaine 0.75% follow with 7ml/hour of ropivacaine 0.2%) as analgesic nerve blockade for total knee replacement surgery. | Drug: Analgesic nerve blockade (Ropivacaine)<br>* Analgesic nerve blockade (Ropivacaine) for total knee replacement surgery.<br>* Other names: Regional anesthesia;Procedure: Total knee replacement surgery.<br>* Total knee replacement surgery.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Pain measurement with numeric pain scale : from 0 to 10 (maximal pain) in rest condition | Pain assessment and evolution in postoperative period (passive condition) | up to day 7 | 
| Pain measurement with numeric pain scale (from 0 to 10) during active motorized mobilization (Kinetic) | Pain assessment and evolution in postoperative period (active condition) | up to day 7 | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Postintervention nausea vomiting | question : present or not | at hour 0, at hours 6, at day 1 | 
| Patient satisfaction | Questionnaire of patient felling and satisfaction. Choice within gradual felling : bad, middle, good, excellent | at day 1 | 
| Opioid consumption | doses of piritramid (synthetic opioid) administrated with patient control rescue analgesia device. | up to 48 hours | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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surgery