An interventional study of Low bolus concentration and volume in Knee Arthropathy, sponsored by Chulalongkorn University. Completed at 1 site in Thailand. Open to participants aged 18 Years and older, including healthy volunteers. Per ClinicalTrials.gov, last updated 2024-08-12.
Sponsored by Chulalongkorn University · Not applicable, Interventional, and Treatment
To investigate the efficacy of two different regimens of local anesthetic boluses for continuous adductor canal block under ultrasound-guidance in total knee arthroplasty at King Chulalongkorn Memorial Hospital.
Total knee arthroplasty (TKA) is a commonly performed surgical procedure for patients with severe knee osteoarthritis. However, one of the challenges associated with TKA is the significant postoperative pain experienced by patients, which can delay early mobilization and physical therapy. Uncontrolled pain worsens patient outcomes and healthcare costs as it can increase the risk of complications after surgery. Therefore, effective pain management is important for optimizing patient outcomes and promoting a smooth recovery process.Despite the absence of a standardized recommendation for the volume and concentration of bolus administration in continuous adductor canal block (CACB), many previous studies, have demonstrated the efficacy of a high-dose bolus followed by a low-concentration local anesthetic infusion for CACB. However, these trials exhibited differences in the doses and volumes of bolus injection. Therefore, the necessity of high concentration and volume bolus CACB in combination with comprehensive multimodal analgesia and LIA for postoperative pain management in TKA remains uncertain. The aim of this study is to investigate the efficacy of two different regimens of local anesthetic used in boluses for continuous adductor canal block under ultrasound-guidance in total knee arthroplasty at King Chulalongkorn Memorial Hospital.
Chulalongkorn University is the lead sponsor of 321 studies on the registry; 64 are open to participants now.
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Exclusion Criteria
0.15% bupivacaine 10 ml boluses for continuous adductor canal block
Drug: Low bolus concentration and volume
0.25% bupivacaine 20 ml boluses for continuous adductor canal block
Drug: Low bolus concentration and volume
Compare Low and Standard concentrations and volumes of bupivacaine boluses for continuous adductor block
Also known as: Low concentration and volume of bupivacaine bolus
Average knee pain score assessed by Numerical rating scale (NRS)
Average postoperative pain score assessed by NRS from 0-10 (0= no pain, 10= the worst pain imaginable)
Time frame: 6 hours after surgery
Average knee pain score assessed by Numerical rating scale (NRS)
Average postoperative pain score assessed by NRS from 0-10 (0= no pain, 10= the worst pain imaginable)
Time frame: 12 hours after surgery
The degree of active range of motion (ROM) of knee joint
Evaluate patient's functional outcomes by the degree of knee active ROM (measured by a goniometer) at preoperative and postoperative day 0,1,2
Time frame: preoperative - postoperative day 2
Functional outcomes assessed by Five Times Sit to Stand Test (5XSST)
Evaluate patient's functional outcomes by 5XSST at preoperative and postoperative day 0,1,2
Time frame: preoperative - postoperative day 2
Functional outcomes assessed by Time Up and Go (TUG) test
Evaluate patient's functional outcomes by TUG tests at preoperative and postoperative day 0,1,2
Time frame: preoperative - postoperative day 2
Postoperative pain score assessed by Numerical rating scale (NRS)
Postoperative pain score at rest and on movement assessed by NRS from 0-10 (0= no pain, 10= the worst pain imaginable)
Time frame: preoperative to day 7 after hospital discharge
Quadriceps strength assessed by maximum voluntary isometric contraction (MVIC) in Newton
Quadriceps strength assessed by MVIC in Newton at 90 degrees at preoperative and postoperative day 0,1,2
Time frame: preoperative - postoperative day 2
morphine consumption in milligrams
Patient's morphine consumption at postoperative day 0,1,2
Time frame: post0perative day 0-2
postoperative complications assessed by Likert scale
postoperative complications such as nausea/vomitting, sleep disturbance and fall assessed by Likert scale from 1-7 (1 = strongly disagree/ extremely unlikely, 2 = disagree/ unlikely, 3 = slightly disagree/ slightly unlikely, 4 = either, 5 = slightly agree/ slightly likely, 6 = agree/ likely, 7 = strongly agree/ extremely likely)
Time frame: postoperative day 0-2
The time to first rescue analgesia
the period from the CACB administration to the first IV morphine administration
Time frame: postoperative day 0-2
Length of hospital stay assessed by hours
Evaluate length of hospital stay (from admission to hospital discharge) by hours
Time frame: postoperative day 2
patient satisfaction assessed by Numerical rating scale (NRS)
Evaluate patient satisfaction by NRS from 0-10 (0= no pain, 10= the worst pain imaginable)
Time frame: 48 hours after surgery and 7 days after hospital discharge
Plan to share: No
This study is completed, as verified in Aug 2024. You cannot join it, but the record below documents what was studied.
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