Continuous Saphenous Block Versus Continuous Femoral Block for Total Knee Arthroplasty

Study Overview
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Brief Summary
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Strength of the Quadriceps Muscle is key to recover from Total Knee Arthroplasty. In this study we compare two techniques for pain control after total knee arthroplasty in terms of preserving the motor function (the strength of the quadriceps muscles of the thigh) which will facilitate the rehabilitation and accelerate the hospital discharge. We will use ultrasound guided technique to block either the femoral nerve in the control group or the saphenous nerve in the experimental group. The primary outcome is the functional capacity and the impact of each block on the ability to walk by measuring the distance patients are able to walk in two minutes in post operative day one in the two groups. The secondary outcome is the morphine consumption in the two groups.

Official Title
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Continuous Saphenous Block Vs. Continuous Femoral Block for Total Knee Arthroplasty: Prospective, Randomized, Double Blind Study.

Conditions
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Total Knee Arthroplasty Secondary to Osteoarthritis

Intervention / Treatment
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* Procedure: continuous femoral nerve block
* Procedure: continuous saphenous nerve block


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: - Subject age over 18 years coming for total knee arthroplasty secondary to osteoarthritis Exclusion Criteria: ASA 4-5 Abnormal liver enzymes, hepatic failure, renal failure and cardiac failure if they become contraindication for the use of regional anesthesia Contraindications for spinal anesthesia Morbid obesity Organ transplant Neuropathic pain History of stroke or major neurological deficit Sensory and motor disorders in the operated limb Previous drug dependency Chronic use of opioids Allergy to local anesthetics Inability to comprehend pain assessment

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

Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Triple


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Active Comparator: femoral block<br> | Procedure: continuous femoral nerve block<br>* ultrasound guided femoral nerve catheter insertion.<br>|
| Experimental: saphenous block<br> | Procedure: continuous saphenous nerve block<br>* ultrasound guided saphenous nerve catheter insertion<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| to assess the functional capacity and the impact of each block on the ability to walk by measuring the distance (the 2 minute walk test) in post op day one in the two groups. |  | post op day one | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| the morphine consumption in the two groups. |  | post op day one |