Clinical trial NCT03208478: Pain Control for Anterior Cruciate Ligament Reconstruction Patients With Adductor Canal or Femoral Perineural Infusions
Official title: A Prospective Comparison of Pain and Quality of Recovery in Patients Undergoing Anterior Cruciate Ligament Reconstruction With Adductor Canal or Femoral Perineural Infusions
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: NA
Conditions: Pain, Postoperative
Anterior Cruciate Ligament Injury
Lead sponsor: Stanford University
Sponsor class: OTHER
First posted: 2017-07-05
Enrollment: 60
Sex: ALL
Minimum age (years): 18
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Allocation: RANDOMIZED
Intervention model: PARALLEL
Primary purpose: TREATMENT

Brief summary: Nerve blocks are used to provide pain control after moderately painful orthopedic surgeries. Anterior Cruciate Ligament (ACL) reconstruction with patellar autograft is a painful orthopedic procedure performed after traumatic injury to the knee. Many patients undergoing ACL reconstruction receive a nerve block as part of their anesthetic care. These blocks can be performed in different locations along the femoral nerve, with advantages and disadvantages to each location. Recently published evidence indicates that there is no short-term difference in pain control between the two commonly-targeted locations ("Adductor Canal" and "Femoral"). However, studies involving patients undergoing total knee arthroplasty indicate that femoral blocks provide better pain control with movement than adductor canal blocks. As many patients undergoing ACL reconstruction use continuous passive motion (CPM) machines as part of rehabilitation starting on post-operative day one, the investigators hypothesize that pain control and quality of recovery in the first 48 hours after surgery will be superior with a continuous femoral block than with a continuous adductor canal block. The investigators plan to study this by randomizing patients presenting for ACL reconstruction to receive either a continuous femoral or continuous adductor canal block (both considered adequate means of pain control), and following them to 48 hours to determine the level of pain, quality of recovery score, opioid use, and CPM compliance.

Detailed description: covery score, opioid use, and CPM compliance.

Eligibility criteria: Inclusion Criteria:

* Adult patients \>18 years
* ASA physical status I, II, or III
* Scheduled for ACL reconstruction surgery with patellar autograft

Exclusion Criteria:

* Pregnancy
* Incarceration
* Age \<18
* BMI \>35
* Pre-operative opioid use \>15 mg morphine equivalents per day
* Inability to communicate with investigators by telephone
* Pre-existing neuropathy of the operative extremity

Primary outcomes:
measure: Pain Score
timeFrame: Post-operative day 2
Secondary outcomes:
measure: Quality of Recovery
timeFrame: POD 2
measure: Opioid Use
timeFrame: POD 2
measure: CPM compliance
timeFrame: POD 2
Other outcomes:
measure: Quality of Recovery
timeFrame: POD 1
measure: Bolus dose usage
timeFrame: POD 2
measure: Return to Play
timeFrame: 3 months
measure: Quadriceps Circumference, percent of baseline
timeFrame: 3 months
Locations:
city: Stanford
country: United States
facility: Stanford University
state: California
Study officials:
affiliation: Stanford University
name: Jean Louis-Horn, MD
role: PRINCIPAL_INVESTIGATOR
References: