The goal of this observational study is to determine the incidence of dislodgement for adductor canal catheters after total knee arthroplasty on post-operative day 1. We will also attempt to identify factors associated with secondary catheter failure.
Total knee arthroplasty (TKA) is a common procedure for indications including osteoarthritis and malignancy involving the knee, with over 55,285 knee replacements performed between 2020-2021 in Canada. Ultrasound guided continuous adductor canal block (cACB) is the standard of care for postoperative analgesia for this procedure. The catheter is not always as effective at providing analgesia as would be expected - which could be due to displacement of the catheter. This displacement is most likely to occur peri-operatively or during physiotherapy post-operatively and as such, post-operative assessments can provide useful insight into causes of secondary failure. This prospective observational study aims to estimate the cACB dislodgment on POD 1 rate at a high volume, tertiary care referral centre, and identify factors associated with dislodgement and clinical sequelae. As this is an observational/QI study of the current standard of care at Sunnybrook Health Sciences Centre, anesthesiologists are free to use the cross sectional versus parallel insertion of the cACB per their discretion.
Study Type
OBSERVATIONAL
Enrollment
100
Ultrasound guided Adductor Canal Catheter for total knee arthroplasty analgesia
Sunnybrook Health Sciences Centre
Toronto, Ontario, Canada
Adductor Canal Catheter tip in correct position on postoperative day 1
Ultrasound confirmation of injectate spread adjacent to the femoral artery on postoperative day 1 (08h00)
Time frame: Postoperative day 1 (08:00AM)
Adductor Canal Catheter tip in correct position after insertion
Ultrasound confirmation of injectate spread adjacent to the femoral artery before surgery
Time frame: Preoperative
Sensory block
Loss of sensation in the saphenous nerve distribution on postoperative day 1 (08h00)
Time frame: Postoperative day 1 (08:00AM)
Postoperative opioid consumption (08h00)
Cumulative opioid consumption after total knee arthroplasty to postoperative day 1 (08h00)
Time frame: Postoperative day 1 (08:00AM)
Numeric Rating Scale for Pain (NRS) at rest on postoperative day 1 (08h00)
Maximum pain score on 0-10 Likert Scale
Time frame: Postoperative day 1 (08:00AM)
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