Clinical trial NCT02125903: Comparison of Continuous Femoral Nerve Block and Adductor Canal Block After Total Knee Replacement Therapy
Official title: Randomized Controlled Study: Comparison of Continuous Femoral Nerve Block and Adductor Canal Block After Total Knee Replacement Therapy Relating to Early Mobilization and Analgesia
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: NA
Conditions: Total Knee Arthroplasty
Total Knee Replacement
Femoral Nerve Block
Adductor Canal Block
Lead sponsor: Philipps University Marburg
Sponsor class: OTHER
First posted: 2014-04-29
Enrollment: 44
Sex: ALL
Minimum age (years): 50
Maximum age (years): 80
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Allocation: RANDOMIZED
Intervention model: PARALLEL
Primary purpose: TREATMENT

Brief summary: The blockade of the femoral nerve (FNB) is the most common postoperative pain therapy after total knee replacement. Because of motor-driven weakness of the quadriceps muscle induced by femoral nerve block mobilization of Patients is difficult even dangerous (falls) and hospital stays are extended.

An alternative method could be an adductor canal block (ACB). Anatomical studies of the adductor canal demonstrated that the adductor canal contains the saphenous nerve, a pure sensory nerve for medial and anterior aspects of the knee and the tibia without any motor function.

This prospective, double-blinded, randomized study investigates the effect of FNB and ACB on quadriceps motor weakness and analgesia determined by Numeric Rating Scale (NRS).

We expect the ACB to be superior in muscle strength but equal in pain score. Both groups receive an additional anterior sciatic nerve block for complete sensory block of the operated knee


Eligibility criteria: Inclusion Criteria:

* patients with knee replacement therapy and general anaesthesia
* informed consent
* preoperative "timed up and go" test performable

Exclusion Criteria:

* emergency patients
* BMI \> 40 kg/m2
* American Society of Anaesthesiologists physical status (ASA) 4-5
* severe chronic obstructive pulmonary disease (COPD)
* rheumatic arthritis, diabetic Polyneuropathy, M. Parkinson
* nerve injury of lumbosacral plexus
* coagulopathy with bleeding tendency
* not capable of speaking or understanding german or english

Primary outcomes:
measure: Timed-Up and Go-test for mobility evaluation
timeFrame: third postoperative day
Secondary outcomes:
measure: Pain Scores
timeFrame: 6, 24, 48, 72 hours postoperative
measure: Quadriceps strength
timeFrame: 6, 24, 28, 72 hours postoperative
measure: Ropivacaine consumption (each catheter)
timeFrame: 24, 48, 72 hours postoperative
measure: CAS (Cumulated Ambulation Score)
timeFrame: 24,48,72 hours postoperative
measure: Mobility Score (MoSc)
timeFrame: 24,48,72 hours postoperative
measure: Analgesic regimen
timeFrame: preop and 0, 6 , 24, 48, 48 hours postoperative
Other outcomes:
Locations:
city: Marburg
country: Germany
facility: University of Marburg Department of Anaesthesia And Intensive Care Medicine
Study officials:
affiliation: Dept. of Anesthesia And Intensiv Care Medicine University of Marburg
name: Karolin Piechowiak, Dr
role: STUDY_DIRECTOR
affiliation: Dept. of Anesthesia And Intensive Care Medicine University of Marburg
name: Thorsten Steinfeldt, Prof Dr
role: STUDY_DIRECTOR
affiliation: Dept. of Anesthesia And Intensive Care Medicine University of Marburg
name: Thomas Wiesmann, Dr
role: STUDY_DIRECTOR
References: