Dexamethasone for iPACK Block With ACB in Total Knee Arthroplasty

Poznan University of Medical Sciences60 enrolled

Overview

Effect of adding Dexamethasone to Infiltration between the Popliteal Artery and Capsule of the Knee Block with ACB in Patients undergoing Total Knee Arthroplasty

Knee arthroplasty is one of the most common orthopaedic procedures, especially in elderly patients, due to the deformation of joints. Patients may complain of severe pain due to surgical trauma and prostheses. Regional anaesthesia methods may be performed to reduce the inflammatory response, opioid consumption, and opioid-related side effects.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

QUADRUPLE

Enrollment

Conditions

Knee Osteoarthritis Knee Pain Chronic Knee Arthritis

Interventions

RopivacaineDRUG

Ultrasound-guided iPACK block + ACB - 2 x (20ml 0,2% ropivacaine + 2ml 0.9% NaCl)

Ropivacaine+DexamethasoneDRUG

Ultrasound-guided iPACK block + ACB - 2 x (20ml 0,2% ropivacaine + 2mg Dexamethasone)

Eligibility

Sex: ALLMin age: 65 YearsMax age: 100 Years

Medical Language ↔ Plain English

Inclusion Criteria: * patients scheduled for total hip arthroplasty * patients aged \>65 and \<100 years * patients able to provide informed consent * patients able to reliably report symptoms to the research team Exclusion Criteria: * inability to provide first-party consent due to cognitive impairment or a language barrier

Locations (1)

Poznan University of Medical Sciences

Poznan, Poznań, Poland

Outcomes

Primary Outcomes

Time to first rescue opioid analgesia

Time after surgery when the patient needs opiate for the first time

Time frame: 48 hours after surgery

Secondary Outcomes

Total Opioid Consumption

Total opiate consumption after surgery

Time frame: 48 hours after surgery

Numerical Rating Scale [range 0:10]

Postoperative pain assessment will be performed using the NRS score (0 = no pain, 10 = the most severe pain felt)

Time frame: 4 hours after surgery

Numerical Rating Scale [range 0:10]

Postoperative pain assessment will be performed using the NRS score (0 = no pain, 10 = the most severe pain felt)

Time frame: 8 hours after surgery

Numerical Rating Scale [range 0:10]

Postoperative pain assessment will be performed using the NRS score (0 = no pain, 10 = the most severe pain felt)

Time frame: 12 hours after surgery

Numerical Rating Scale [range 0:10]

Postoperative pain assessment will be performed using the NRS score (0 = no pain, 10 = the most severe pain felt)

Time frame: 24 hours after surgery

Numerical Rating Scale [range 0:10]

Postoperative pain assessment will be performed using the NRS score (0 = no pain, 10 = the most severe pain felt)

Time frame: 48 hours after surgery

Quadriceps muscle strength assessed using medical research council scale [range 0:5]

Data from ClinicalTrials.gov

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Quadriceps muscle strength (knee extension and hip adduction) will be evaluated according to the medical research council muscle strength rating

Time frame: 4 hours after surgery

Quadriceps muscle strength assessed using medical research council scale [range 0:5]

Quadriceps muscle strength (knee extension and hip adduction) will be evaluated according to the medical research council muscle strength rating

Time frame: 8 hours after surgery

Quadriceps muscle strength assessed using medical research council scale [range 0:5]

Quadriceps muscle strength (knee extension and hip adduction) will be evaluated according to the medical research council muscle strength rating

Time frame: 12 hours after surgery

Quadriceps muscle strength assessed using medical research council scale [range 0:5]

Quadriceps muscle strength (knee extension and hip adduction) will be evaluated according to the medical research council muscle strength rating

Time frame: 24 hours after surgery

Quadriceps muscle strength assessed using medical research council scale [range 0:5]

Quadriceps muscle strength (knee extension and hip adduction) will be evaluated according to the medical research council muscle strength rating

Time frame: 48 hours after surgery

Nerve damage [range 0-4]

Nerve damage assesment will be performed using the nerve damage score (N0- no nerve damage; N1- minor - sensory paresthesia; N2- major -complete sensory anesthesia; N3- Complete- complete motor defect with or without paraesthesia; N4-CRPS- Complex Regional Pain Syndrome)

Time frame: 12 hours after surgery

Nerve damage [range 0-4]

Time frame: 24 hours after surgery

Nerve damage [range 0-4]

Time frame: 48 hours after surgery

glucose

blood glucose level

Time frame: 12 hours after surgery

glucose

blood glucose level

Time frame: 24 hours after surgery

glucose

blood glucose level

Time frame: 48 hours after surgery