One common anesthetic that is performed for total knee replacement surgery is spinal anesthesia with an adductor canal regional block, which involves injecting numbing medication in the thigh region for pain control after surgery. The aim of this study is to determine whether the addition of another regional block called obturator nerve block, which involves injecting numbing medication in the upper thigh region, will improve pain control after surgery while not sacrificing mobility after surgery.
There is currently no consensus on the optimal strategy that provides the most effective postoperative analgesia while preserving ambulation and limiting side effects such as nausea and vomiting. The clinical team's hypothesis is that the obturator nerve block in addition to adductor canal block can target both the anterior and posterior distribution of nerves to the knee to provide superior analgesia while not limiting ambulation. To test this hypothesis, the clinical team will compare the rate of IV opioid consumption in patients who receive a combination of adductor canal block and obturator nerve block at the surgical site versus patients who receive adductor canal block alone.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
QUADRUPLE
Enrollment
60
Obturator nerve regional block involves the injection of a local anesthetic called bupivacaine into the upper thigh.
Adductor canal regional block, which involves injecting numbing medication in the thigh region for pain control.
Saline as placebo comparator
Icahn School of Medicine at Mount Sinai
New York, New York, United States
Morphine Equivalence Consumption
Total amount of opioids consumed
Time frame: up to 24 hours after surgery
Pain Score
Likert scale ranging from 0-10 - 0 being no pain, and 10 being the worst pain ever experienced
Time frame: 1, 6, 12, and 24 hours after surgery
Number of Participants With Nausea or Vomiting
Yes or No responses when the subject is asked if the subject is feeling nauseous or has vomited
Time frame: up to 24 hours after surgery
Time to Ambulation
The length of time that it takes before the patient is first able to walk with assistance after surgery as assessed by a physical therapist.
Time frame: on postoperative day 1 after surgery
Time to Breakthrough Pain Medication
Time before pain medication needed for breakthrough pain
Time frame: up to post operative day 2 after surgery
Analgesia Satisfaction Score
Analgesia Satisfaction Score - Full scale from 0-10 with higher score indicating higher satisfaction.
Time frame: 2 weeks after surgery
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