Nerve Block for Postoperative Pain
What You Need to Know Before You Apply
What is the purpose of this trial?
This trial aims to determine if a continuous nerve block, specifically an Adductor Canal Block, provides better pain relief after knee replacement surgery compared to a single injection. Patients will receive either a one-time nerve block or an ongoing nerve block for five days. The study will monitor pain levels, painkiller use, and progress in physical therapy for a week after surgery. Individuals planning a knee replacement and not regular opioid users might be suitable for this trial. As a Phase 4 trial, this research involves an FDA-approved treatment and seeks to understand its benefits for more patients, offering participants a chance to contribute to improving post-surgery pain management.
Will I have to stop taking my current medications?
The trial does not specify if you need to stop taking your current medications. However, if you use opioids or tramadol daily in amounts greater than 20 mg of oxycodone equivalents for more than 4 weeks, you cannot participate.
What is the safety track record for the adductor canal block treatments?
Research has shown that the continuous adductor canal block, used after knee replacement surgery, is generally well-tolerated. One study found no major side effects when this method was used, even without ultrasound guidance, suggesting it is quite safe. Additionally, this continuous nerve block has been linked to better pain relief and faster recovery compared to other methods.
Both the continuous and single injection adductor canal blocks use ropivacaine, a local pain reliever. Studies have demonstrated that treatments using ropivacaine effectively reduce pain without significant side effects.
Overall, both approaches have been used safely in clinical settings, with no major safety concerns reported.12345Why are researchers enthusiastic about this study treatment?
Researchers are excited about the adductor canal block treatments for postoperative pain because they offer a potentially more effective and sustained pain relief method compared to traditional pain management techniques. Unlike standard postoperative care, which often involves oral pain medications like opioids, the single injection adductor canal block uses ropivacaine to target nerves directly, reducing the need for systemic drugs and their side effects. The continuous adductor canal block goes a step further by providing a prolonged, 5-day infusion of ropivacaine, which may offer consistent pain control and enhance recovery by minimizing pain over an extended period. These treatments aim to provide more localized and sustained pain relief, potentially improving patient comfort and reducing reliance on conventional oral medications.
What evidence suggests that this trial's treatments could be effective for postoperative pain?
Studies have shown that the adductor canal block effectively manages pain after knee surgery. In this trial, participants will receive either a single injection adductor canal block or a continuous adductor canal block. The single injection method can relieve pain, but patients may still experience varying pain levels, with some reporting severe discomfort. Research suggests that the continuous adductor canal block, which delivers a steady flow of medication, might control pain more effectively. This method has been associated with lower pain levels and reduced need for additional pain medication. Both treatments use ropivacaine, a local anesthetic, to help manage post-surgery pain.36789
Are You a Good Fit for This Trial?
This trial is for adults over 50 kg who are having their first knee replacement surgery and plan to receive a single-injection nerve block. It's not suitable for those with conditions that exclude them from the study, which aren't specified here.Inclusion Criteria
Exclusion Criteria
Timeline for a Trial Participant
Screening
Participants are screened for eligibility to participate in the trial
Preoperative
Participants receive either a single injection or a continuous adductor canal block with ropivacaine
Postoperative Treatment
Participants are monitored for pain, opioid consumption, and physical therapy milestones from postoperative day 0 to 7
Follow-up
Participants are assessed for pain scores, opioid consumption, and physical and emotional functioning at 30 days postoperatively
What Are the Treatments Tested in This Trial?
Interventions
- Adductor Canal Block
Trial Overview
The study compares two types of pain control after knee surgery: one group gets a continuous nerve block through an OnQ pump, while the other receives a single injection. The goal is to see which method better reduces pain and opioid use, and helps patients reach physical therapy goals within the first week post-surgery.
How Is the Trial Designed?
2
Treatment groups
Experimental Treatment
Active Control
single injection with ropivacaine (0.5%) of the adductor canal block and a 5-day continuous perineural infusion of ropivacaine (0.2%) (experimental group)
single injection with ropivacaine (0.5%) of the adductor canal block and no continuous nerve block added
Find a Clinic Near You
Who Is Running the Clinical Trial?
University of California, San Diego
Lead Sponsor
Citations
The effects of continuous catheter adductor canal block for ...
It is anticipated that CACB will be more effective in reducing postoperative pain than SACB, leading to decreased rescue analgesia usage and ...
2.
kneesurgrelatres.biomedcentral.com
kneesurgrelatres.biomedcentral.com/articles/10.1186/s43019-023-00188-0The effects of continuous catheter adductor canal block for ...
It is anticipated that CACB will be more effective in reducing postoperative pain than SACB, leading to decreased rescue analgesia usage and ...
Continuous Adductor Canal Block in Outpatient Total Knee ...
Secondary objectives are to evaluate postoperative pain scores, postoperative use of opioid, postoperative functional status, complications relating to the ...
4.
journals.lww.com
journals.lww.com/cmii/fulltext/2024/22030/to_compare_the_effects_of_0_2__ropivacaine.4.aspxTo Compare the Effects of 0.2% Ropivacaine Continuous...
This study aimed to compare scheduled intermittent bolus and continuous local anaesthetic (LA) infusion to determine which provides more effective analgesia.
The analgesic efficacy of the continuous adductor canal ...
In this study, the continuous ACB provided superior analgesia and fewer side effects without any significant motor deficit than the IV-PCA with ...
Continuous Adductor Canal Block used for postoperative ...
Secondary outcomes included serial postoperative pain scores, rate of patients with NRS>3 at rest and movement within 24 and 48 h ...
Postoperative continuous adductor canal block for total ...
Postoperative continuous adductor canal block for total knee arthroplasty improves pain and functional recovery: A randomized controlled clinical trial.
8.
bmcmusculoskeletdisord.biomedcentral.com
bmcmusculoskeletdisord.biomedcentral.com/articles/10.1186/s12891-025-09087-9Efficacy of direct adductor canal block in pain control and ...
No major adverse effects were observed in this study. Given that ACB was performed without ultrasound guidance, safety was a primary concern.
9.
dovepress.com
dovepress.com/comparison-of-the-effects-of-adductor-canal-and-femoral-nerve-blocks-o-peer-reviewed-fulltext-article-JPREffectiveness & safety of adductor canal block treatment | JPR
Conclusion: The ACB and FNB groups exhibited comparable clinical efficacy outcomes in terms of pain scores and opioid consumption. However, the ...
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