The Impact of Intravenous Vitamin C Combined With Nerve Blocks on Postoperative Pain and Recovery After Total Knee Arthroplasty

Study Overview
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Brief Summary
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The aim of this prospective randomized-control study was to evaluate the impact of a single high-dose intravenous vitamin C added to ultrasound-guided blocks at induction on postoperative pain, sngception and early functional rehabilitation of the knee joint in patients under-going total knee arthroplasty.

Official Title
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The Impact of Intravenous Vitamin C Combined With Nerve Blocks on Postoperative Pain and Recovery After Total Knee Arthroplasty.

Conditions
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Ascorbic Acid, Postoperative Pain

Intervention / Treatment
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* Drug: Ascorbic acid 5000mg
* Drug: Control Rx


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Physical status according to American Society of Anesthesiologists (ASA) I-III Patients scheduled for total knee arthroplasty Age ranging from 50 to 80 years old Exclusion Criteria: Previous operation on the same knee Allergy or intolerance to one of the study medications Coagulopathy Having lower limbs neuropathy End-organ failure (CKD stage V or VI, NYHA III or IV) BMI > 35 Chronic opioid use or drug abuser Difficulty in communication (Impaired mental status) Hyperuricemia or Glucose-6-phosphate dehydrogenase deficiency patient

Ages Eligible for Study
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Minimum Age: 50 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: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Triple


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Vitamin C arm<br>Intravenous loading of 5g ascorbic acid before incision of wound | Drug: Ascorbic acid 5000mg<br>* Intravenous loading of 5000mg ascorbic acid with normal saline, totally 100ml Completed before surgical incision<br>|
| Placebo Comparator: Control arm<br>Intravenous loading of the same volume Normal saline as experimental arm | Drug: Control Rx<br>* Intravenous loading 100ml normal saline<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Visual analogue scale for pain | Marking on a continuous 10 centimeter line from 0 to 10, representing no pain to worst pain | 15 minutes postoperatively | 
| Visual analogue scale for pain | Marking on a continuous 10 centimeter line from 0 to 10, representing no pain to worst pain | first hour postoperatively | 
| Visual analogue scale for pain | Marking on a continuous 10 centimeter line from 0 to 10, representing no pain to worst pain | 6th hour postoperatively | 
| Visual analogue scale for pain | Marking on a continuous 10 centimeter line from 0 to 10, representing no pain to worst pain | 24th hour postoperatively | 
| Visual analogue scale for pain | Marking on a continuous 10 centimeter line from 0 to 10, representing no pain to worst pain | 48th hour postoperatively | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Visual analogue scale for sngcetion | Marking on a continuous 10 centimeter line from 0 to 10, representing no sore to worst sore | 48 hours postoperatively | 
| Morphine consumption | Amount of IM morphine consumption in the first 24 hours postoperatively | 24 hours postoperatively | 
| Time to first rescue morphine requirement at post-anesthetic care unit | Duration from arriving post-anesthetic care unit to requiring first morphine injection | up to 2 hours | 
| Severity of postoperative nausea/ vomiting and dizziness | From 0 to 5, 0: non, 1: mild, 2: moderate, 3: severe, 4: unbearable | 48 hours postoperatively | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Ascorbic Acid, Total knee arthroplasty, Regional analgesia