Early rehabilitation after anterior cruciate ligament reconstruction is of paramount importance and requires optimal pain control based on a multimodal concept, including injection of local anaesthetics. Regarding this latter, different options have emerged recently such as the adductor canal block, performed before the surgery by the anaesthesiologist or the infiltration of the articulation performed by the surgeon at the of the intervention. No trial has compared these two approaches. As practice of medicine should be based on evidence, we decided to undertake this randomised controlled trial where we compared the adductor canal block with the local infiltration analgesia technique in terms of pain and functional outcomes
Patients scheduled to undergo anterior cruciate ligament reconstruction under general anaesthesia will be randomly allocated to two groups: local infiltration analgesia or adductor canal block. The local infiltration analgesia will be performed by the surgeon at the end of surgery with 20 mLs of ropivacaine 0.5%. The adductor canal block will be performed by the anaesthesiologist under ultrasound guidance after the surgery, before awaking the patient, using the same solution (20 mLs ropivacaine 0.5%) Postoperative analgesia will include intravenous patient-controlled analgesia of morphine (settings 1 mg/ml, 2 ml/10 minutes, 40 mg/4 hours), ibuprofen (3x400 mg) and acetaminophen (4x1000 mg). A research assistant and a physiotherapist, both blinded to the group allocation, will collect pain and rehabilitation data, respectively.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
TRIPLE
Enrollment
104
Injection of the local anesthetic at the end of surgery, either in the surgical sites by the surgeon, or in the adductor canal block by the anesthesiologist under ultrasound guidance.
Department of Anesthesia, Centre Hospitalier Universitaire Vaudois and University of Lausanne
Lausanne, Canton of Vaud, Switzerland
Total morphine consumption (mg)
Time frame: 24 h postoperatively
Total morphine consumption (mg)
Time frame: 2 h postoperatively
Total morphine consumption (mg)
Time frame: 48 h postoperatively
Total morphine consumption (mg)
Time frame: 72 h postoperatively
Pain scores (numeric rating scale, 0-10) at rest and on movement
Time frame: 2 h postoperatively
Pain scores (numeric rating scale, 0-10) at rest and on movement
Time frame: 12 h postoperatively
Pain scores (numeric rating scale, 0-10) at rest and on movement
Time frame: 24 h postoperatively
Pain scores (numeric rating scale, 0-10) at rest and on movement
Time frame: 36 h postoperatively
Pain scores (numeric rating scale, 0-10) at rest and on movement
Time frame: 48 h postoperatively
Pain scores (numeric rating scale, 0-10) at rest and on movement
Time frame: 60 h postoperatively
Pain scores (numeric rating scale, 0-10) at rest and on movement
Time frame: 72 h postoperatively
Postoperative nausea and vomiting (yes/no)
Time frame: 24 h postoperatively
Postoperative nausea and vomiting (yes/no)
Time frame: 48 h postoperatively
Postoperative nausea and vomiting (yes/no)
Time frame: 72 h postoperatively
Pruritus (yes/no)
Time frame: 24 h postoperatively
Pruritus (yes/no)
Time frame: 48 h postoperatively
Pruritus (yes/no)
Time frame: 72 h postoperatively
Active flexion
Flexion of the knee by the patient measured in degrees
Time frame: 24 h postoperatively
Active flexion
Flexion of the knee by the patient measured in degrees
Time frame: 48 h postoperatively
Active flexion
Flexion of the knee by the patient measured in degrees
Time frame: 72 h postoperatively
Quadriceps muscle strength (numeric scale, 1-5)
Time frame: 24 h postoperatively
Quadriceps muscle strength (numeric scale, 1-5)
Time frame: 48 h postoperatively
Quadriceps muscle strength (numeric scale, 1-5)
Time frame: 72 h postoperatively
Distance walked (meters)
Time frame: 24 h postoperatively
Distance walked (meters)
Time frame: 48 h postoperatively
Distance walked (meters)
Time frame: 72 h postoperatively
Anterior Cruciate Ligament - Return to Sport after Injury scale
Time frame: 4 months postoperatively
Anterior cruciate ligament -Return to Sport after Injury scale
Time frame: 8 months postoperatively
International Knee Documentation Committee score
Time frame: 4 months postoperatively
International Knee Documentation Committee score
Time frame: 8 months postoperatively
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