Clinical trial NCT02539628: Adductor Canal Block With Continuous Infusion Versus Intermittent Boluses and Morphine Consumption
Official title: Adductor Canal Block With Continuous Infusion Versus Intermittent Boluses and Morphine Consumption: A Randomized, Triple-masked, Controlled Study
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: PHASE4
Conditions: Postoperative Pain
Lead sponsor: Rigshospitalet, Denmark
Sponsor class: OTHER
Collaborators: name: University of California, San Diego
name: Bispebjerg Hospital
name: Smiths Medical, ASD, Inc.
First posted: 2015-09-03
Enrollment: 110
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: The investigators believe sufficient spread to all nerves within the adductor canal-and thereby sufficient analgesia-can only be obtained by bolus injections and not by continuous infusions via a catheter. The aim of the study is to investigate whether an adductor canal block performed as repeated intermittent boluses provides superior pain relief to continuous infusion. The investigators hypothesize that adductor canal block performed as intermittent boluses via a catheter will reduce morphine consumption and pain as well as enhance ambulation and muscle strength compared with continuous infusion.


Eligibility criteria: Inclusion Criteria:

* Patients scheduled for total knee arthroplasty in spinal anesthesia
* Patients who gave their written informed consent to participating in the study after having fully understood the contents of the protocol and restrictions
* American society of anesthesiologists 1-3
* Ability to perform a timed up and go test preoperatively

Exclusion Criteria:

* Patients who cannot cooperate
* Patients who cannot understand or speak Danish.
* Patients with allergy to the medicines used in the study
* Patients with a daily intake of strong opioids (morphine, oxycodone, ketobemidone, methadone, fentanyl) during the last 4 weeks
* Patients suffering from alcohol and/or drug abuse - based on the investigator's assessment
* Rheumatoid arthritis
* BMI \> 40
* Neuromuscular pathology in the lower limbs
* Pregnancy

Primary outcomes:
measure: Total opioid consumption
timeFrame: 2 days postoperative
Secondary outcomes:
measure: Pains scores during knee flexion as assessed by the Visual analogue scale (VAS)
timeFrame: 2 days postoepratively
measure: Pain at rest as assessed by the VAS pain scores
timeFrame: 2 days postoperatively
measure: Pain during the Timed Up and Go test as assessed by the VAS
timeFrame: 1 and 2 days postoperatively
measure: Quadriceps strength assessed as maximum voluntary isometric contraction in percentage of preoperative baseline values at 12 pm on POD 1 and 2
timeFrame: 1 and 2 days postoperatively
measure: Timed Up and Go test
timeFrame: 1 and 2 days postoperatively
measure: Number of patients able to perform the Timed Up and Go test
timeFrame: 1 and 2 days postoperatively
measure: 6 min walk test
timeFrame: 1 and 2 days postoperativley
Other outcomes:
Locations:
city: Gentofte
country: Denmark
facility: Department of Anaesthesia-Surgery-Intensive Care, Gentofte Hospital
state: Hellerup
Study officials:
References:
citation: Jaeger P, Baggesgaard J, Sorensen JK, Ilfeld BM, Gottschau B, Graungaard B, Dahl JB, Odgaard A, Grevstad U. Adductor Canal Block With Continuous Infusion Versus Intermittent Boluses and Morphine Consumption: A Randomized, Blinded, Controlled Clinical Trial. Anesth Analg. 2018 Jun;126(6):2069-2077. doi: 10.1213/ANE.0000000000002747.