Femoral Versus Adductor Canal Continuous Peripheral Nerve Blocks for Knee Arthroplasty
Completed · Phase 4
Conditions studied: Postoperative Pain Following Knee Arthroplasty
In brief
Patients typically experience moderate-to-severe pain following knee arthroplasty that is usually treated with a combination of oral and intravenous analgesics and enhanced by continuous peripheral nerve blocks. There are currently two locations to place a perineural catheter to provide analgesia following knee arthroplasty: a femoral nerve catheter and an adductor canal catheter. Both have been demonstrated to be effective following knee arthroplasty. However, it remains unknown if one location is superior to the other; or, more accurately, what the relative benefits are to each technique. While femoral CPNB has many benefits, one of the challenges of using this technique is that there is a decrease in quadriceps muscle strength which can be a limiting factor for rehabilitation. In contrast, the adductor canal catheter affects only the vastus medialis. This block may lessen block-induced quadriceps weakness following knee arthroplasty compared with a femoral infusion. The investigators hypothesize that compared with femoral perineural local anesthetic infusion, an adductor canal infusion is associated with a shorter time until four discharge criteria are met: (1) adequate analgesia; (2) independence from intravenous analgesics; (3) ability to ambulate 30 m; and (4) ability to stand, walk 3 m, and return to a sitting position without another's assistance.
Key facts
- Study ID
- NCT01759277
- Run by
- University of California, San Diego
- People needed
- 80
- Starts
- 2012-12-01
- Expected to finish
- 2014-09-01
- Last updated by the study team
- 2021-02-18
Who can join
Age: 18 and older. Sex: any. Healthy volunteers: not accepted.
You may qualify if…
- primary, unilateral knee arthroplasty
- age ≥ 18 years
- postoperative analgesic plan includes perineural local anesthetic infusion of 48-72 hours
You may not qualify if…
- morbid obesity as defined by a body mass index >40 (BMI=weight in kg/ [height in meters]
- chronic, high-dose opioid use (greater than 20mg oxycodone-equivalent opioid use daily within the 2 weeks prior to surgery and duration of use >4 weeks)
- history of opioid abuse
- allergy to study medications
- known renal insufficiency (creatinine > 1.5 mg/dL)
- pregnancy
- incarceration
- any known neuro-muscular deficit of the ipsilateral femoral nerve, obturator nerve and/or quadriceps muscle (including diabetic peripheral neuropathy); and inability to ambulate 30 m preoperatively.
Where it is running
- University of California San Diego Medical Centers — San Diego, California, United States
Full record on ClinicalTrials.gov
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