Suprainguinal Fascia Iliaca Block vs. Periarticular Injection for Total Knee Arthroplasty

Study Overview
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Brief Summary
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Total knee replacement (total knee arthroplasty) is performed to resurface a knee damaged by arthritis and relieve pain in patients with severely damaged knee joints. Total knee arthroplasty (TKA) is associated with severe postoperative pain, and the management of postoperative pain continues to evolve with the advancement of surgical techniques and pharmacological treatments. Femoral, lateral femoral cutaneous nerve and obturator nerve block is provided with suprainguinal fascia iliaca plan block, which is used for postoperative analgesia, especially in hip surgeries. In this way, the investigators think it can be used as a part of multimodal analgesia in total knee arthroplasty surgery.

Official Title
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Ultrasound Guided Suprainguinal Fascia Iliaca Block vs. Periarticular Injection for Total Knee Arthroplasty: Prospective Randomized Study

Conditions
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Analgesia

Intervention / Treatment
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* Other: Group Suprainguinal fascia iliaca block
* Other: Group Periarticular Infiltration


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: American Society of Anesthesiologist's physiologic state I-III patients Total knee arthroplasty Exclusion Criteria: BMI>35 liver, kidney, and advanced heart failure, routine use of analgesics and having used analgesics in the last 24 hours, having neuropathic pain, refusal to participate in the study

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 70 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 |
| --- | --- |
| Active Comparator: Group Suprainguinal fascia iliaca block<br>Suprainguinal fascia iliaca block after the surgery | Other: Group Suprainguinal fascia iliaca block<br>* After the operation is completed, the fascia iliaca will be separated from the iliacus muscle. With ultrasound guidance, the local anesthetic injection will be made between the fascia and the muscle.<br>|
| Active Comparator: Group Periarticular Infiltration Group<br>A local anesthetic will be applied to the medial and lateral capsule, the medial and lateral meniscus margins, the deep part of the medial ligament, the medial and lateral synovial space, and the patellar ligament and quadriceps tendon. | Other: Group Periarticular Infiltration<br>* A total volume of 80 ml local anesthetic will be applied to the medial and lateral capsule, the medial and lateral meniscus margins, the deep part of the medial ligament, the medial and lateral synovial space, and the patellar ligament and quadriceps tendon.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Postoperative opioid consumption | First 24 hours total fentanyl consumption with patient controlled analgesia | first 24 hours | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Visual analog pain score | Post operative pain will be evaluated with a Visual Analogue Scale (between 0-10; 0: no pain, 10:worst pain) score | first 48 hours | 
| timed up and go test (TUG) | TUG- evaluation of the time in seconds for the patient to get up from the chair and walk 3 meters and return to the chair again | at 24th hour | 
| quadriceps muscle strength | will be evaluated in a scale between 1-5 (1:lowest; 5:normal) | at 24th hour | 
| joint range of motion test (ROM) | will be measured with goniometer( between 0-180 degrees) | at 24th hour | 
| Five Time Sit to Stand Test (FTSST) | physical assistance of the patient getting up and sitting down 'as fast as possible' five times without | at 24th hour |