The blockade of the femoral nerve (FNB) is the most common postoperative pain therapy after total knee replacement. Because of motor-driven weakness of the quadriceps muscle induced by femoral nerve block mobilization of Patients is difficult even dangerous (falls) and hospital stays are extended. An alternative method could be an adductor canal block (ACB). Anatomical studies of the adductor canal demonstrated that the adductor canal contains the saphenous nerve, a pure sensory nerve for medial and anterior aspects of the knee and the tibia without any motor function. This prospective, double-blinded, randomized study investigates the effect of FNB and ACB on quadriceps motor weakness and analgesia determined by Numeric Rating Scale (NRS). We expect the ACB to be superior in muscle strength but equal in pain score. Both groups receive an additional anterior sciatic nerve block for complete sensory block of the operated knee
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
DOUBLE
Enrollment
44
Regional Anesthesia performed with 0.375% Ropivacaine 15ml (56,25mg)
University of Marburg Department of Anaesthesia And Intensive Care Medicine
Marburg, Germany
Timed-Up and Go-test for mobility evaluation
The patient is observed and timed while he rises from an arm chair, walks 3 meters, turns, walks back, and sits down again.
Time frame: third postoperative day
Pain Scores
Numeric Rating Scale (NRS), 0-10 for Rest / Stress. in Addition total Body NRS Pain
Time frame: 6, 24, 48, 72 hours postoperative
Quadriceps strength
Numeric Scale (0-5)
Time frame: 6, 24, 28, 72 hours postoperative
Ropivacaine consumption (each catheter)
Measurement of the total amount
Time frame: 24, 48, 72 hours postoperative
CAS (Cumulated Ambulation Score)
Cumulated Ambulation Score is calculated with routine data. Measurement for ambulation ability
Time frame: 24,48,72 hours postoperative
Mobility Score (MoSc)
Is calculated with routine data. Measurement for overall mobilization (none- passive mobilization, sitting, standing, walking with walking device, walkin free or with crutches)
Time frame: 24,48,72 hours postoperative
Analgesic regimen
Documentation of analgesic prescriptions and rescue medications during postoperative course
Time frame: preop and 0, 6 , 24, 48, 48 hours postoperative
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