Knee joints, one of the largest and most functional joints of the human body, have great features to provide ideal body posture and movement. In patients with knee osteoarthritis in whom pain and functional loss continue to increase despite conservative and medical burden, they are evaluated by orthopedic surgeons for surgical treatment. Total knee replacement (TKR) surgery is aimed to eliminate the existing pain, restore and carry the movements, to protect the characteristics of the deformities and the quality of life. Pain can be very severe after TKR surgery, which is very common in the middle and elderly patient population today. In the postoperative period, untreated pain prevents early physical therapy practices and restricts postoperative knee rehabilitation and recovery, but it also has negative effects on the respiratory, gastrointestinal, renal, and central nervous systems. Effective management of postoperative acute pain can reduce these complications and the risk of developing chronic pain. In this study, investigators hypothesized that combined adductor canal and sciatic nerve block, applied with postoperative ultrasound guidance to patients who will undergo TKR surgery under general anesthesia, will provide effective analgesia, less opioid consumption, and faster ambulation time, similar to combined femoral and sciatic nerve block.
As a result of the power analysis investigators conducted for this study, the minimum sample size was calculated as 34 people for each group, 68 people in total, at the 95% confidence interval. 68 patients who meet the inclusion criteria will be included in our study. Patients will be randomized and divided into 2 groups. Accordingly, femoral and sciatic nerve blocks will be applied to 34 patients, and adductor canal and sciatic nerve blocks will be applied to 34 patients.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
DIAGNOSTIC
Masking
QUADRUPLE
Enrollment
68
The investigators will perform a combined adductor canal \& sciatic nerve block on that patient group for postoperative analgesia
The investigators will perform a combined femoral \& sciatic nerve block on that patient group for postoperative analgesia
The investigators will perform a combined adductor canal \& sciatic nerve block on that patient group for postoperative analgesia with bupivacaine and prilocaine hydrochloride
The investigators will perform a combined femoral \& sciatic nerve block on that patient group for postoperative analgesia with bupivacaine and prilocaine hydrochloride
Bakirkoy Dr. Sadi Konuk Research and Training Hospital
Istanbul, Bakirkoy, Turkey (Türkiye)
The primary outcome measure of the study is the patients' postoperative pain scores (NRS)
Numerical rating scale (NRS) at 1, 6, 12, 18, 24, 48, 72th hours. NRS assessment score ranges from 0-10. 0 = no pain 10 = worst pain imaginable
Time frame: 72 hours postoperatively
The secondary outcome measure will be total opioid consumption in the first 72 hours postoperatively
PCA device will be prepared with 4 mg tramadol (400 mg/100 cc) per ml and total opioid consumption for 72 hours will be noted
Time frame: Three days postoperatively
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