Adductor Canal Block (ACB) Before and After Primary Total Knee Arthroplasty (TKA)
Status:
Completed
Trial end date:
2018-01-01
Target enrollment:
Participant gender:
Summary
Total knee arthroplasty (TKA) is associated with severe postoperative pain. Multimodal
analgesia, including peripheral nerve block, is recommended for post-operative pain relief 1.
Perineural analgesia offers the advantage of extended pain relief up to 24 hours after
surgery2.
This is a prospective, randomized control trial designed to compare the analgesic efficacy of
the adductor canal block (ACB) performed immediately before or immediately after primary
total knee arthroplasty (TKA). The primary objective of this study is to measure pain score
associated with knee motion following TKA among patients receiving ACB as part of their
analgesic regimen for TKA. Secondary end points include assessment of postoperative
ambulation, range of motion, pain at rest, opioid consumption, and patient satisfaction
between the two analgesic approaches. The investigators hypothesize that ACB before the
surgery will reduce a patient's postoperative pain and improve patient satisfaction.
All consecutive patients undergoing primary TKA will be recruited for enrollment in the
study. Patients will be for randomized preoperatively to receive either preemptive ABC
(PreACB) or postoperative ABC (PostACB). Patients randomized to the PreACB group will receive
the block prior to incision. Patients randomized to the PostACB group will receive the block
at the end of the surgery. Both techniques are in accordance to the standard of care at our
institute. All patients will have the ACB done by a regional anesthesiologist in the regional
anesthesia unit, or in the operating room. Patient medical history will be obtained and
blocks will be placed per usual protocol. Operative and anesthetic details, including
medications given, will be recorded.
Pain scores and pain medications given in the PACU will be recorded. Supplementary analgesics
will be provided per institutional PACU protocol. Study data will be recorded for up to 72
hours or until patient discharge. A follow-up will occur in 4- 6 weeks at the orthopedic
follow-up appointment to evaluate the patient's late pain scores and overall satisfaction.
Data will be analyzed both at the conclusion of the study and at several intervals prior to
completion of the study.