Adductor canal blocks (ACB) have been recommended in total knee arthroplasty (TKA) to provide better control of post-operative pain, facilitate early ambulation, and reduce length of stay in the hospital. ACB is typically done before surgery by an anesthesiologist, which may increase time per case, cost, and requires the specialized skills of an anesthesiologist trained in regional anesthesia. Recent studies have suggested that surgeons can safely and reliably administer the adductor canal blocks (sACB) during surgery. However, there is currently very limited data on the clinical efficacy of such sACBs, and no studies assessing this technique in the context TKA that are discharged the same day. As such, this randomized control trial (RCT) is being done to compare sACBs to conventional anesthesiologist-performed adductor canal blocks (aACB).
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
OTHER
Masking
NONE
Enrollment
80
The patient will undergo a pre-operative single-shot, ultrasound-guided ACB performed by an anaesthesiologist skilled in regional anaesthesia techniques. The ACB will be performed in a dedicated block room, immediately prior to administration of a spinal anaesthetic.
The patient will undergo an intraoperative single-shot ACB performed by the treating surgeon following placement of the TKA components.
The Ottawa Hospital
Ottawa, Ontario, Canada
RECRUITINGPatient Report Pain
Mean Numerical Pain Rating Scale (NPRS) scores on discharge
Time frame: Up to 24 hours
Pain medication use
morphine equivalents of pain medication
Time frame: When spinal anesthesia resolves until 24 hours after surgery
Time to discharge
Post-operative time in minutes to discharge home
Time frame: From PACU to discharge
Admission to Hospital
Failure to discharge home requiring admission
Time frame: Up to 24 hours post-operative
Readmission Rate
Number of patients readmitted to the hospital within 24 hours
Time frame: Up to 24 hours post-operative
Timed Up and Go Test
Time is takes, in seconds, to stand, walk 3m, turn around, walk back 3m, and sit back down
Time frame: At discharge
Patient Reported Quality of Recovery
Score on the Quality of Recovery-15 questionnaire
Time frame: At 24 hours post-operative
Patient Reported Function
Difference in scores on the Oxford knee score (questionnaire), rated from 0-48 with 48 being the best functional outcome and 0 being the worst
Time frame: pre-operatively, at 2 weeks post-operative
Patient Reported Quality of Life
Difference in scores on the EQ-5D-5L questionnaire (Euro Quality of Life, 5 Dimension, 5 Level), rated from 11111 - 55555, with 11111 being full health and 55555 being worst health
Time frame: pre-operatively, at 2 weeks post-operative
Patient Reported Global Health
Difference in scores on the PROMIS-10 - Global Health (questionnaire), which generates T-scores. Higher T-scores indicate better health.
Time frame: pre-operatively, at 2 weeks post-operative
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