Clinical trial NCT05961085: Incidence of Adductor Canal Catheter Dislodgment
Official title: Positioning of Continuous Adductor Canal Catheters After Total Knee Arthroplasty
Study type: OBSERVATIONAL
Overall status: ACTIVE_NOT_RECRUITING
Conditions: Total Knee Arthroplasty
Lead sponsor: Sunnybrook Health Sciences Centre
Sponsor class: OTHER
First posted: 2023-07-27
Enrollment: 100
Sex: ALL
Minimum age (years): 50
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Observational model: COHORT
Time perspective: PROSPECTIVE
Sampling method: NON_PROBABILITY_SAMPLE
Study population: All patients referred to Sunnybrook Health Sciences Centre scheduled for primary total knee arthroplasty

Brief summary: The goal of this observational study is to determine the incidence of dislodgement for adductor canal catheters after total knee arthroplasty on post-operative day 1. We will also attempt to identify factors associated with secondary catheter failure.

Detailed description: Total knee arthroplasty (TKA) is a common procedure for indications including osteoarthritis and malignancy involving the knee, with over 55,285 knee replacements performed between 2020-2021 in Canada. Ultrasound guided continuous adductor canal block (cACB) is the standard of care for postoperative analgesia for this procedure. The catheter is not always as effective at providing analgesia as would be expected - which could be due to displacement of the catheter. This displacement is most likely to occur peri-operatively or during physiotherapy post-operatively and as such, post-operative assessments can provide useful insight into causes of secondary failure. This prospective observational study aims to estimate the cACB dislodgment on POD 1 rate at a high volume, tertiary care referral centre, and identify factors associated with dislodgement and clinical sequelae. As this is an observational/QI study of the current standard of care at Sunnybrook Health Sciences Centre, anesthesiologists are free to use the cross sectional versus parallel insertion of the cACB per their discretion.

Eligibility criteria: Inclusion Criteria:

* Patients scheduled for Total Knee Arthroplasty
* Older than 50 years

Exclusion Criteria:

* Body Mass Index greater than 40
* Chronic opioid consumption (greater than 30mg oral morphine equivalent daily)
* Contraindication to Adductor Canal Catheter

Primary outcomes:
measure: Adductor Canal Catheter tip in correct position on postoperative day 1
timeFrame: Postoperative day 1 (08:00AM)
Secondary outcomes:
measure: Adductor Canal Catheter tip in correct position after insertion
timeFrame: Preoperative
measure: Sensory block
timeFrame: Postoperative day 1 (08:00AM)
measure: Postoperative opioid consumption (08h00)
timeFrame: Postoperative day 1 (08:00AM)
measure: Numeric Rating Scale for Pain (NRS) at rest on postoperative day 1 (08h00)
timeFrame: Postoperative day 1 (08:00AM)
Other outcomes:
measure: Adductor catheter occlusion
timeFrame: Postoperative day 1 (08:00AM)
measure: Patient satisfaction with analgesia on postoperative day 1
timeFrame: Postoperative day 1 (08:00AM)
Locations:
city: Toronto
country: Canada
facility: Sunnybrook Health Sciences Centre
state: Ontario
Study officials:
References: