Optimal Location of Nerve Block to Minimize Perioperative Opioid Administration in ACL Surgery: Comparing True Adductor Canal to Proximal Block

Study Overview
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Brief Summary
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This is a prospective, randomized, single blinded trial involving human subjects. The goal of this study is to determine an optimal location (proximal or distal) for the nerve block and whether it will make a difference in how much opioid the patient will receive during and after surgery. Ultrasound will identify the adductor canal and the proximal end of the adductor canal/apex of the femoral triangle to determine the location of the blocks. Their will be two randomized groups: 1. ACB within true AC with bupivacaine 0.5% 20cc2. ACB proximal to true AC with bupivacaine 0.5% 20cc

Official Title
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Optimal Location of Nerve Block to Minimize Perioperative Opioid Administration in ACL Surgery: Comparing True Adductor Canal to Proximal Block

Conditions
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ACL Surgery

Intervention / Treatment
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* Drug: ACB within true AC with bupivacaine 0.5% 20cc
* Drug: ACB proximal to true AC with bupivacaine 0.5% 20cc


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Patients undergoing unilateral, ACL surgery with allograft. Patients who consent to be randomized. Patients must be English proficient. Exclusion Criteria: Patients younger than 18 or older than 75 years of age; Patients with a history of chronic pain or who are taking medications intended to treat chronic pain such as strong opioids; Patients with history of neurologic disorder that can interfere with pain sensation; Patients with a history of drug or alcohol abuse; Patients who are unable to understand or follow instructions; Patients with an allergy or a contraindication to any of the medications used in the study, or patients with a contraindication to any of the study procedures; Patients with severe liver disease, renal insufficiency, congestive heart failure, and/ or significant heart disease; Patients with a BMI over 42; Any patient that the investigators feel cannot comply with all study related procedures. Patients who do not tolerate Percocet.

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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No

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: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Active Comparator: ACB within true AC with bupivacaine<br>The patients will receive an ultrasound-guided single injection adductor canal block with 20 mL of 0.5% bupivacaine | Drug: ACB within true AC with bupivacaine 0.5% 20cc<br>* The adductor canal block (ACB) is more commonly being used to provide post-operative analgesia since it provides a sensory block with minimal motor block.<br>* Other names: bupivacaine;|
| Active Comparator: ACB proximal to true AC with bupivacaine<br>The patients will receive an ultrasound-guided single injection femoral triangle block with 20 mL of 0.5% bupivacaine | Drug: ACB proximal to true AC with bupivacaine 0.5% 20cc<br>* Patients will receive ultra-sound guided single femoral triangle block injection with 20 mL of 0.5% bupivicaine<br>* Other names: bupivacaine;|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Total Opioid Consumption Intraop Measured by Amounts of Morphine Equivalents | Amount of morphine equivalents administered intraoperatively in 24 hours | 24 Hours | 
| Total Opioid Consumption Postop Measured by Amounts of Morphine Equivalents | Amount of morphine equivalents administered postoperatively in 24 hours | 24 Hours | 
| Side Effects Such as Nausea, Itching, Constipation. |  | 24 hours | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Motor Block (Muscle Weakness): in PACU and Measured in Surgeons' Clinic at 3, 6 and 12 Months. |  | 12 months |