This is a randomized, double-blinded pilot study to determine whether patients undergoing ambulatory total knee arthroplasty (TKA) using a subvastus approach benefit from the addition of a continuous adductor canal nerve block (cACB) catheter along with an existing multimodal approach to postoperative analgesia. Outcomes include the 15-item Quality of Recovery Scale (QoR-15) (Miles 2016), pain scores, opioid consumption, opioid-free days, functional outcome as measured by the Time Up and Go (TUG) test, patient satisfaction, patient's rating of catheter effectiveness, and complications.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
SUPPORTIVE_CARE
Masking
QUADRUPLE
Enrollment
81
This is the placebo intervention - normal saline infused in the adductor canal via a catheter. There are no anticipated therapeutic effect
This is the treatment intervention - ropivacaine 0.2% infused in the adductor canal via a catheter. This will provide analgesia to the knee after TKA
The Ottawa Hospital, General Campus
Ottawa, Ontario, Canada
Quality of Recovery Scale 15 (QoR-15)
QoR-15 is a validated scale calculated from a 15-question patient questionnaire. It is an aggregate score that evaluates recovery after surgery.
Time frame: at 4pm on post-operative day (POD) 1
Quality of Recovery Scale 15 (QoR-15)
Time frame: POD 2-4 + 7
Pain score at rest
Patients will rate their pain on a scale of 0-10
Time frame: POD 1-4 + 7
Pain score with activity
Patients will rate their pain on a scale of 0-10
Time frame: POD 1-4 + 7
Tapentadol consumption
Daily tapentadol use in milligrams
Time frame: POD 1-4 + 7
Patient satisfaction
Patients will be asked "are you satisfied with your pain control"
Time frame: POD 1-4 + 7
Vital signs - blood pressure, heart rate, oxygen saturation
These measurements will be obtained via post-operative home monitoring system
Time frame: twice daily POD 1-4
Patient-rated catheter effectiveness
Patients will be asked "do you think the nerve block catheter is helpful? Rate on a 5-point scale"
Time frame: POD 1-4
Catheter specific complications
Patients will be asked daily to report these potential nerve block catheter related issues: (1) leakage around the dressing (2) occlusion/blockage of the pump (3) inadvertent catheter disconnection (4) swelling around the catheter site (5) bleeding or bruising around the catheter site (6) other complications
Time frame: POD 1-4
Peri-operative complications
Significant peri-operative complications resulting in return to emergency department, re-admission after discharge, or return to operating room will be reported
Time frame: POD 30
Timed-up-and-go (TUG) test
TUG is a validated test to assess a person's mobility. It has been used to evaluate functional recovery after orthopedic surgeries. This will be administered on POD 14 at the surgeon's office during the post-operative follow-up visit
Time frame: POD 14
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