Nerve Block for Total Knee Replacement
(CACB Trial)
What You Need to Know Before You Apply
What is the purpose of this trial?
Total knee arthroplasty (TKA) is a frequent performed surgery. Many institutions are implementing fast track programs for this surgery and adequate pain management is an important feature. Analgesic duration of single shot nerve blocks is limited to no more than 24h. Conversely, the use of continuous nerve block (CNB) through a perineural catheter and infusion of local anesthetic may increase duration of analgesia and provide better outcomes. The purpose of this study is to evaluate effectiveness and safety of using CNB in patients undergoing ambulatory TKA, and its effects on patients' quality of recovery. Investigators hypothesize that continuous adductor canal block would lead to decrease in opioid consumption in patients undergoing fast track TKA.Significance There are no published prospective randomized controlled trials to assess patient's reported quality of recovery after receiving CACB in same day primary knee arthroplasties. As this is a frequent type of surgery and has the prediction to increase its incidence for the next years, there is significant importance in investigations about interventions which may improve its recovery in a fast track regime. A postoperative analgesic technique that offers better pain control, has less adverse effects, reduces the opioid analgesia requirement and is safe to be used in a fast track setting may have additional impact on decreasing health care cost and may lead to an enhanced recovery and better quality of life.Objectives To evaluate effectiveness and safety of using CACB in patients undergoing ambulatory TKA, in comparison to SACB. Primary objective is opioid consumption (in oral morphine equivalent doses) Secondary objectives are to evaluate postoperative QoR-15 scores (10), pain scores, opioid-induced adverse effects (measured via validated opioid symptom distress scale), postoperative functional status, complications relating to the perineural catheter and readmissions.
Who Is on the Research Team?
Naveed Siddiqui, MD
Principal Investigator
Associate Professor
Are You a Good Fit for This Trial?
This trial is for adults over 21 years old who are having a knee replacement in a fast track program and have no drug or alcohol dependency. They must be generally healthy (ASA I-III), not dependent on opioids, without allergies to the study drugs, coagulopathy, low platelets, or issues that prevent catheter placement at the surgery site.Inclusion Criteria
Exclusion Criteria
Timeline for a Trial Participant
Screening
Participants are screened for eligibility to participate in the trial
Preoperative Preparation
Patients undergo pre-anesthesia consultation and receive study information and consent forms
Treatment
Patients receive either continuous adductor canal block or sham block during and after surgery
Postoperative Monitoring
Data collection on opioid consumption, pain intensity, and quality of recovery
Follow-up
Participants are monitored for safety and effectiveness after treatment
What Are the Treatments Tested in This Trial?
Interventions
- Continuous Adductor Canal Block
Find a Clinic Near You
Who Is Running the Clinical Trial?
Samuel Lunenfeld Research Institute, Mount Sinai Hospital
Lead Sponsor