Continuous Nerve Block for Post-Knee Replacement Pain
What You Need to Know Before You Apply
What is the purpose of this trial?
This trial tests a new method for managing pain after knee replacement surgery called continuous adductor canal block (CACB). The researchers aim to determine if this approach offers longer-lasting pain relief and improves recovery compared to a placebo. Individuals undergoing first-time knee replacement surgery who expect to leave the hospital within a day or so might be suitable candidates. The trial will compare the effects of an actual pain relief solution with a placebo to assess effectiveness and safety. As an unphased trial, it provides patients the chance to contribute to innovative pain management research that could enhance recovery experiences for future patients.
Will I have to stop taking my current medications?
The trial information does not specify if you need to stop taking your current medications. However, if you are using chronic opioids equivalent to 30mg of morphine daily, you would not be eligible to participate.
What prior data suggests that continuous adductor canal block is safe for post-knee replacement pain management?
Research has shown that the continuous adductor canal block (CACB) is generally safe for individuals undergoing knee replacement surgery. This pain control method uses a small tube to deliver a steady flow of numbing medicine and is well-tolerated by most patients. Some studies suggest that CACB not only aids in pain relief but also enhances knee movement after surgery.
One study indicated that adductor canal blocks, in general, are safe and effective in reducing pain after knee surgery. This suggests that using them continuously might also be safe, though it requires careful monitoring. While any medical treatment can have side effects, research on CACB has shown that serious issues are rare.
In summary, CACB appears to be a safe option for managing pain after knee replacement, based on current evidence. However, discussing potential risks with a healthcare provider before joining a trial is always advisable.12345Why are researchers excited about this trial?
Researchers are excited about continuous adductor canal block (CACB) for post-knee replacement pain because it offers a targeted approach that may provide more consistent pain relief compared to traditional pain management methods like opioid medications. Unlike oral painkillers, CACB delivers a local anesthetic, ropivacaine, directly to the adductor canal, potentially reducing systemic side effects and the risk of opioid dependency. This localized delivery could lead to quicker recovery times and better mobility after surgery, making it a promising alternative for enhancing post-operative care.
What evidence suggests that continuous adductor canal block is effective for post-knee replacement pain?
Research shows that a continuous adductor canal block (CACB), which participants in this trial may receive, can effectively manage pain after knee replacement surgery. Studies have found that CACB significantly reduces pain and the need for additional pain medication. For instance, one study discovered that patients using CACB required fewer opioids, which are strong painkillers, compared to those who received a sham continuous adductor canal block (ShACB), the placebo treatment in this trial. Another study demonstrated that patients had better muscle strength after surgery when using CACB. Overall, CACB helps patients recover more comfortably and effectively after knee surgery.14678
Who Is on the Research Team?
Naveed Siddiqui, MD, MSc
Principal Investigator
University of Toronto
Are You a Good Fit for This Trial?
This trial is for patients over 21 years old who are having knee replacement surgery as outpatients and have a moderate risk of complications (ASA I-III). They should not be dependent on alcohol or drugs, understand the treatment process, and cannot be using strong painkillers regularly. People with allergies to study meds, blood clotting issues, low platelet counts, or problems where the catheter goes can't join.Inclusion Criteria
Exclusion Criteria
Timeline for a Trial Participant
Screening
Participants are screened for eligibility to participate in the trial
Pre-surgery Assessment
Pre anesthesia consult and study explanation, including consent form review
Treatment
Patients undergo total knee arthroplasty with continuous adductor canal block or sham block
Follow-up
Participants are monitored for catheter associated complications and quality of recovery
What Are the Treatments Tested in This Trial?
Interventions
- Continuous adductor canal block (CACB)
- Sham continuous adductor canal block (ShACB)
Find a Clinic Near You
Who Is Running the Clinical Trial?
University of Toronto
Lead Sponsor
MOUNT SINAI HOSPITAL
Collaborator