Adductor Canal Versus Femoral Nerve Block for Analgesia Post Total Knee Arthroscopy

Study Overview
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Brief Summary
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Total knee arthroplasty or replacement (TKA) is a surgery performed for osteoarthritis of the knee which is increasingly performed as the population ages. It is a painful surgery and one of the methods to reduce post-operative pain is performing a regional anaesthesia technique. The current practice is to perform a femoral nerve block (FNB) which blocks the nerves supplying the knee joint and the thigh muscles (quadriceps). This provides effective analgesia. However, it also results in weakness of the quadriceps and may result in falls post-operatively. Adductor canal block (ACB) is a new, alternative regional anaesthesia technique which is hypothesised to provide as effective analgesia, with less quadriceps weakness compared to FNB, hence potentially reducing the risk of falls post-operatively. Investigators aim to study if the analgesia provided by ACB is as good as FNB while preserving quadriceps strength.

Official Title
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A Randomised Controlled Trial Comparing Single Shot Adductor Canal Block With Femoral Nerve Block for Analgesia Post Total Knee Arthroplasty

Conditions
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Knee Osteoarthritis

Intervention / Treatment
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* Drug: Ropivacaine


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: ages 45-85 American Society of Anaesthesiologists physical status 1-3 BMI 18-35 kg/m2 Exclusion Criteria: inability to give consent, communicate, cooperate Patients with regular consumption of strong opioids (morphine, oxycodone) or steroids Patients with allergy to local anaesthetics or any drugs included in the study Patients with lower limb surgery in the preceding year Patients with pre-existing neurological deficits Patients who are unsuitable for general anaesthetics (eg difficult airway)

Ages Eligible for Study
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Minimum Age: 45 Years
Maximum Age: 85 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: Double


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Active Comparator: Femoral Nerve Block<br>Femoral Nerve block performed with 0.5% Ropivacaine 30mls (150mg) | Drug: Ropivacaine<br>* 30mls of 0.5% ropivacaine<br>* Other names: naropin;|
| Active Comparator: Adductor Canal block<br>Adductor Canal block performed with 0.5% Ropivacaine 30mls (150mg) | Drug: Ropivacaine<br>* 30mls of 0.5% ropivacaine<br>* Other names: naropin;|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Morphine consumption |  | first 24 hours | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Pain scores |  | 1, 6, 12, 24, 48 | 
| Morphine consumption |  | 48 hours | 
| Side effects of opioids- sedation, nausea and vomiting |  | 48 hours | 
| Quadriceps strength, ability to mobilise |  | 24, 48 hours | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Total knee arthroplasty, Total knee replacement, Femoral Nerve Block, Adductor Canal Block