Single-injection Adductor Canal Block for Total Knee Arthroplasty Under Spinal Anesthesia

Study Overview
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Brief Summary
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This study evaluates the effect of the single-injection adductor canal block in patients receiving total knee arthroplasty under spinal anesthesia.

Detailed Description
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This study aims to evaluate the effect of the single-injection adductor canal block in patients receiving total knee arthroplasty under spinal anesthesia. The effect of the single-injection adductor canal and continuous adductor canal block in patients receiving total knee arthroplasty under general anesthesia has been well established. However, due to the residual effect of spinal anesthesia, the effect of the single-injection adductor canal block needs to be determined. The investigators hypothesize that the single-injection adductor canal block will decrease the total sum of 2h, 6h, 12h, and 24h pain score.

Official Title
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The Effect of Postoperative Single-injection Adductor Canal Block for Multimodal Pain Control in Patients Receiving Total Knee Arthroplasty Under Spinal Anesthesia

Conditions
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Total Knee Arthroplasty

Intervention / Treatment
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* Procedure: adductor canal block
* Procedure: control group


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: adult patients receiving total-knee arthroplasty under spinal anesthesia ASA class 1-3 Exclusion Criteria: infection at the needle injection site hard for pain evaluation CRPS patient with lower extremity symptom chronic opioid user those with side effect to local anesthetics those getting revision total-knee arthroplasty or with the previous operation at the same knee area those getting the surgery under general anesthesia due to the failed spinal anesthesia

Ages Eligible for Study
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Minimum Age: 19 Years
Maximum Age: 80 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: Triple


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Sham Comparator: control group<br>normal saline injection | Procedure: control group<br>* After the end of the surgery, at the arrival of PACU, the patient's leg is prepared and draped in a sterile manner. Assisted by the high-frequency linear ultrasound transducer, we target the mid-thigh level and the 22-gauge/8cm needle is introduced in plain through the sartorius muscle. the correct position for the tip of the needle in the adductor canal is checked and a bolus injection of normal saline15ml is given.<br>|
| Experimental: test group<br>0.5% ropivacaine injection | Procedure: adductor canal block<br>* After the end of the surgery, at the arrival of PACU, the patient's leg is prepared and draped in a sterile manner. Assisted by the high-frequency linear ultrasound transducer, we target the mid-thigh level and the 22-gauge/8cm needle is introduced in plain through the sartorius muscle. the correct position for the tip of the needle in the adductor canal is checked and a bolus injection of 0.5% ropivacaine 15ml is given.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| the sum of pain score | VAS pain score (0 to 10) is measured using numeric pain rating scale at 2 hours, 6 hours, 12 hours, and 24 hours 0: no pain, 10: worst pain | 2 hours, 6 hours, 12 hours, and 24 hours after intervention | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Postoperative nausea and vomiting | degree of postoperative nausea and vomiting (0 to 3) 0: no nausea, no vomiting, 1: nausea present, but no vomiting, 2: nausea present, vomiting once, 3: vomiting repeatedly within 30 minutes. | 2 hours, 6 hours, 12 hours, and 24 hours after intervention | 
| Postoperative opioid consumption | amount of postoperative opioid consumption based on oral morphine equivalent daily dose | 2 hours, 6 hours, 12 hours, and 24 hours intervention |