Total knee replacement (TKR) is considered the most effective and safe method of radical treatment of late stages of knee osteoarthritis. A well-known problem of TKR is a severe postoperative pain syndrome, which is observed in more than 50% of patients. Femoral nerve block (FNB) is the "gold standard" for continuous postoperative analgesia after total knee replacement, as it is effective in reducing the frequency of use of opioid analgetics and reduce the duration of hospitalization. At the same time, the negative effect of this method is the motor blockade of the quadriceps femoris muscle which leads to functional impairment and is associated with an increased risk of falling. Adductor canal block (ACB) provides adequate analgesia comparable to femoral nerve block. Moreover, ACB doesn't affect the motor function of the quadriceps femoris muscle. The possibility of enhanced recovery after total knee replacement is the reason to compare single-shot adductor canal block and continuous femoral nerve block.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
TRIPLE
Enrollment
220
Postoperative analgesia in this group will be carried out by a single-shot bolus of 20 ml Ropivacaine 0.5% in the region of the middle third of the adductor canal.
Postoperative analgesia in this group will be carried out by continuous infusion of local anesthetics through a catheter installed to the femoral nerve in the area of the femoral triangle. Ropivacaine 0.2% solution will be used for postoperative analgesia. Local anesthetic infusion rate is 4 ml/h to 10 ml/h.
Clinical Hospital on Yauza
Moscow, Russia
RECRUITINGAmbulation distance
Less meters means worse outcome
Time frame: postoperative day 1
Ambulation distance
Less meters means worse outcome
Time frame: postoperative day 2
Timed up and go test
More seconds means worse outcome
Time frame: postoperative day 1
Timed up and go test
More seconds means worse outcome
Time frame: postoperative day 2
10 meters walk test
More seconds means worse outcome
Time frame: postoperative day 1
10 meters walk test
More seconds means worse outcome
Time frame: postoperative day 2
30 seconds chair stand test
Less exercise done means worse outcome
Time frame: postoperative day 1
30 seconds chair stand test
Less exercise done means worse outcome
Time frame: postoperative day 2
5 times sit to stand test
More seconds means worse outcome
Time frame: postoperative day 1
5 times sit to stand test
More seconds means worse outcome
Time frame: postoperative day 2
time to readiness to dicharge
time from the day of surgery to the day of readiness to discharge
Time frame: 30 day
length of hospitalization
time from the day of surgery to the day of discharge
Time frame: 30 day
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