Analgesic Value of Adductor Canal vs Femoral Block After Total Knee Arthroplasty

Study Overview
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Brief Summary
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An observational study of the effect of femoral nerve block in addition to an adductor canal block for pain following total knee arthroplasty.

Detailed Description
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Subjects undergoing total knee arthroplasty will receive a preoperative adductor canal block with continuous catheter. Following a standardized general anesthetic for the procedure, subjects will be asked to rate their pain using the NRS-11 pain scale in the recovery room. Once the pain is reported at a 5/10 or above, a femoral nerve block will be performed using either 2% chloroprocaine or saline placebo (randomized). Pain scores are then evaluated over the next 30 minutes by a blinded investigator to determine if the femoral block adds any additional analgesic benefit over an adductor canal block.

Official Title
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Evaluation of the Comparative Analgesic Value of Adductor Canal Block Versus Femoral Block Following Total Knee Arthroplasty

Conditions
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Osteo Arthritis Knee

Intervention / Treatment
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* Procedure: Active comparator: chloroprocaine
* Procedure: Sham comparator: saline


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Patients scheduled for elective total knee arthroplasty ASA Physical Status I-III BMI 18-40 kg/m2 Exclusion Criteria: Inability to cooperate with protocol Inability to understand or speak English Allergy to any local anesthetic Chronic opioid consumption/abuse (30 or more morphine mg equivalents/day) Contraindication to adductor canal or femoral nerve block

Ages Eligible for Study
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Minimum Age: 56 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
Interventional Model Description: randomized, blinded observational study
Masking: Triple


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Active Comparator: chloroprocaine<br>15 ml of 2% chloroprocaine via a femoral nerve block technique | Procedure: Active comparator: chloroprocaine<br>* 15 ml of 2% chloroprocaine was placed under ultrasound guidance adjacent to the femoral nerve in the operative limb.<br>* Other names: femoral nerve block with chloroprocaine;|
| Sham Comparator: saline<br>15 ml of 0.9% saline via a femoral nerve block technique | Procedure: Sham comparator: saline<br>* 15 ml of normal saline was placed under ultrasound guidance adjacent to the femoral nerve in the operative limb.<br>* Other names: femoral nerve block with normal saline;|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Pain Intensity as Measured by 11-point Verbal Numeric Rating Scale (NRS-11) for Pain. | Pain intensity prior to intervention and at 5 minute intervals after intervention. The 11-point Numeric Rating Scale quantifies a subject's pain experience from 0/10 (no pain) to 10/10 (worst pain imaginable). | Baseline, up to 30 minutes. | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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femoral nerve block, adductor canal block, analgesia