An interventional study of Adductor Canal catheter delivering 0.0625% L- Bupivacaine and Femoral nerve catheter delivering 0.0625% L- Bupivacaine in Total Knee Replacement, sponsored by University Hospital Plymouth NHS Trust. Terminated at 1 site in United Kingdom. Open to participants aged 18 Years to 85 Years. Per ClinicalTrials.gov, last updated 2019-09-06.
Sponsored by University Hospital Plymouth NHS Trust · Not applicable, Interventional, and Treatment
Open-labelled, randomised controlled trial. Patients will be assessed pre-operatively, at 24 and 48 hours for the primary outcome and secondary outcomes (except for Oxford Knee Score which will be assessed pre-operatively and at 6 months post-operatively by the ortho-paedic team).
Primary Objective: To demonstrate whether adductor canal nerve infusions result in superior patient mobilisation within the first 48 hours following total knee replacement compared to femoral nerve catheter infusions.
Secondary Objective: To identify whether adductor canal nerve infusions result in superior analgesia within the first 48 hours following total knee replacement compared to femoral nerve catheter infusions.
We are comparing a continuous adductor canal block with a low concentration continuous femoral nerve block. We currently use a low dose femoral nerve catheter based technique as part of our standard treatment strategy for total knee arthroplasty. The use of a catheter provides prolonged analgesia compared to a single shot block, and also allows a lower concentration of local anaesthetic to be employed, thus potentially reducing the incidence of motor blockade. The concentration of local anaesthetic employed in our routine practice (0.0625% L- Bupivacaine) is lower than that routinely used in many other centres, and most clinical studies have compared higher concentrations of local anaesthetic - this might be expected to produce more motor blockade. The concentration we use is higher than the minimum effective concentration for a femoral catheter infusion for knee arthroplasty.
University Hospital Plymouth NHS Trust is the lead sponsor of 53 studies on the registry; 7 are open to participants now.
Counted across the registry records on this site, refreshed daily.
Exclusion Criteria:
Femoral nerve catheter delivering 0.0625% L- Bupivacaine: Blockade at level of Femoral crease. Identify femoral nerve. In plane lateral approach. Bolus 20 mls via needle. Catheter threaded and 2-4cm left in situ (bevel orientated cephalad).and 5 mls injected via catheter to confirm spread under ultrasound guidance. Glue/Lockit dressing.
Procedure: Femoral nerve catheter delivering 0.0625% L- Bupivacaine
Adductor canal catheter delivering 0.0625% L- Bupivacaine: Blockade at mid-thigh. Identify sartorius at mid thigh - find point where the femoral artery begins to descend from sartorius. In plane technique, hydro-dissect space between sartorius and femoral artery. Catheter threaded and 2-4cm left in situ (bevel orientated cephalad). Bolus 20 mls via needle and 5 mls via catheter to confirm spread under ultrasound guidance. Glue/Lockit dressing.
Procedure: Adductor Canal catheter delivering 0.0625% L- Bupivacaine
Adductor canal catheter: Blockade at mid-thigh. Identify sartorius at mid thigh - find point where the femoral artery begins to descend from sartorius. In plane technique, hydro-dissect space between sartorius and femoral artery. Catheter threaded and 2-4cm left in situ (bevel orientated cephalad). Bolus 20 mls via needle and 5 mls via catheter to confirm spread under ultrasound guidance. Glue/Lockit dressing.
Also known as: Adductor Canal Block (0.0625% L- Bupivacaine)
Femoral nerve catheter: Blockade at level of Femoral crease. Identify femoral nerve. In plane lateral approach. Bolus 20 mls via needle. Catheter threaded and 2-4cm left in situ (bevel orientated cephalad).and 5 mls injected via catheter to confirm spread under ultrasound guidance. Glue/Lockit dressing.
Also known as: Femoral nerve Block (0.0625% L- Bupivacaine)
Timed Up Go (TUG) test
This measures the time (in seconds) taken by a patient to rise to their feet from a sitting position, walk 3 metres in a straight line, turn around, walk back to the seat and sit down again.
Time frame: 24 hours post-op
Timed Up Go (TUG) test
This measures the time (in seconds) taken by a patient to rise to their feet from a sitting position, walk 3 metres in a straight line, turn around, walk back to the seat and sit down again.
Time frame: 48 hours post-op
Total opiate consumption
morphine equivalence
Time frame: 48 hours post-op
Visual Analogue Score (VAS) for pain
Both at rest and on active movement
Time frame: 24 and 48 hours post-op
Range of knee flexion
The range of flexion movement (in degrees) is recorded using a goniometer
Time frame: 24 and 48 hours post-op
Maximum Voluntary Isometric Contraction (MVIC)
The quadriceps muscle power in the operative leg is assessed using a handheld dynamometer (HHD)
Time frame: 24 and 48 hours post-op
Oxford Knee Score (OKS)
Patient reported outcome score.
Time frame: Pre-op, and at 6 months post-op
This study is terminated, as verified in Aug 2019. You cannot join it, but the record below documents what was studied.
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University Hospital Plymouth NHS Trust