Patient Satisfaction and Postoperative Analgesia Between Subarachnoid Block With 2-chloroprocaine Versus General Anesthesia for Knee Arthroscopy

Study Overview
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Brief Summary
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The study evaluates the efficacy of two different anesthetic techniques in patients undergoing unilateral knee arthroscopy. Participants will be randomized to receive either subarachnoid block with 2-chloroprocaine or general anesthesia plus intravenous fentanyl.

Detailed Description
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The study evaluates the efficacy of two different anesthetic techniques in patients undergoing unilateral knee arthroscopy. Participants will be randomized to receive either subarachnoid block with 2-chloroprocaine or general anesthesia plus intravenous fentanyl. The study evaluates pain scores, opioid utilization and patient satisfaction.

Official Title
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Randomized Controlled Trial Evaluating Patient Satisfaction and Postoperative Analgesia Between Subarachnoid Block With 2-chloroprocaine Versus General Anesthesia for Knee Arthroscopy

Conditions
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Knee Arthroscopy, General Anesthesia, Subarachnoid Block

Intervention / Treatment
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* Procedure: General anesthesia
* Procedure: Subarachnoid block


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Patients with ASA physical status classification of I, II, or III Patients without a current diagnosis of chronic pain or chronic opioid use for > 1-month prior to knee arthroscopy Patients who are scheduled to undergo unilateral knee arthroscopy Patients do not have a contraindication to receiving regional anesthesia Exclusion Criteria: Preexisting sensory or motor deficit in operative extremity Patients with a contraindication to general anesthesia Patient undergoing meniscal or ligamentous repair

Ages Eligible for Study
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Minimum Age: 30 Years
Maximum Age: 65 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: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Subarachnoid block<br> | Procedure: Subarachnoid block<br>* Neuraxial anesthesia will be performed at the L2-3 or L3-4 interspace with a 25-gauge Whitacre needle in the sitting position. After free flow of cerebrospinal fluid (CSF), 40-45mg of 2-chloroprocaine will be injected based on patient's height and discretion of attending anesthesiologist, needle withdrawn and the patient placed supine.<br>|
| Active Comparator: General anesthesia<br> | Procedure: General anesthesia<br>* General anesthesia will be delivered per standard procedure. General anesthesia will include induction with propofol 1-3mg/kg followed by placement of a laryngeal mask airway with maintenance anesthesia of sevoflurane 0.5-1 minimum alveolar concentration (MAC).<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Pain score | Pain score measured with a patient reported 11 point Numeric Rating Pain Scale with 0 indicating no pain and 10 indicating worst pain imaginable. | Discharge from post anesthesia care unit (PACU) (usually one hour) | 
| Pain score | Pain score measured with a patient reported 11 point Numeric Rating Pain Scale with 0 indicating no pain and 10 indicating worst pain imaginable. | Post operative day one | 
| Pain score | Pain score measured with a patient reported 11 point Numeric Rating Pain Scale with 0 indicating no pain and 10 indicating worst pain imaginable. | One month postoperatively | 
| Pain score | Pain score measured with a patient reported 11 point Numeric Rating Pain Scale with 0 indicating no pain and 10 indicating worst pain imaginable. | Three months postoperatively | 
| Opioid utilization | Opioid utilization based on amount of opioid medications administered | Surgical completion to PACU discharge (usually one hour) | 
| Opioid utilization | Opioid utilization based on number of pain pills taken | Postoperative day one | 
| Opioid utilization | Opioid utilization based on average number of pain pills taken per day | One month postoperatively | 
| Opioid utilization | Opioid utilization based on average number of pain pills taken per day | Three months postoperatively | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Patient satisfaction with anesthetic | Patient satisfaction with anesthetic based on 10-item patient satisfaction survey validated for regional and general anesthesia | 24 hours after PACU discharge |