Prospective Femoral Versus Femoral and Sciatic Nerve Block for Anterior Cruciate Ligament (ACL) Reconstruction

Study Overview
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Brief Summary
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The investigators propose that a preoperative femoral and sciatic blocks vs a femoral block only, prior to ambulatory anterior cruciate ligament (ACL) reconstruction will lead to a decrease in opiate consumption, pain scores, and post-anesthesia care unit (PACU) length of stay. The investigators are prospectively randomizing patients to either a femoral or a fem/sciatic block and monitor outcomes.

Detailed Description
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Although femoral nerve blocks improve analgesia after anterior cruciate ligament (ACL) reconstruction, patients often complain of posterior knee pain, which can be treated with a sciatic nerve block. In a prospective randomized study, we compare preoperative femoral nerve block to a combined femoral and sciatic block in patients undergoing ambulatory ACL reconstruction. We hypothesize that the combined femoral/sciatic nerve block patients would have improved analgesia, fewer opioid-related side effects, and shorter PACU length of stay and improved patient satisfaction.

Official Title
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The Addition of a Preoperative Sciatic Nerve Block to a Femoral Nerve Block for Ambulatory Arthroscopic ACL Reconstruction

Conditions
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Anterior Cruciate Ligament Tear

Intervention / Treatment
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* Procedure: Sciatic Block
* Procedure: Femoral Block only


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Age 18 and over ASA status I-II Scheduled for ambulatory Arthroscopic ACL Surgery Exclusion Criteria: Allergy to Local anesthetics or opiates used in the study Contraindications for regional anesthesia coagulopathy, anticoagulation, Thrombocytopenia infection at site of injection Chronic pain and high preoperative opiate requirements High risk for PONV

Ages Eligible for Study
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Minimum Age: 18 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: Femoral and Sciatic Block<br>Administration of preoperative femoral and sciatic nerve blocks | Procedure: Sciatic Block<br>* Performing a sciatic block in addition to a femoral block preoperatively<br>|
| Other: Femoral Block Only<br>Administration of a femoral nerve block prior to surgery | Procedure: Femoral Block only<br>* Performing a preoperative sciatic nerve block only<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Pain Scores |  | PACU and POD1, 2 and 3. | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Length of stay |  | Duration of stay in the recovery room | 
| Opiate consumption |  | During surgery, recovery room and for 3 days after discharge | 
| PONV |  | During the recovery room stay and after discharge from surgery center for up to 3 days. | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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ACL reconstruction, Femoral Block, Sciatic Block