Pain After Total Knee Arthroplasty: A Trial Examining Combined Adductor-canal Nerve Block and Periarticular Infiltration Versus Adductor Canal Nerve Block Versus Periarticular Infiltration
Total Knee Arthroplasty, Postoperative Pain
About this trial
This is an interventional treatment trial for Total Knee Arthroplasty focused on measuring Total Knee Arthroplasty, Pain, Periarticular infiltration, Adductor canal block, Postoperative
Eligibility Criteria
Inclusion Criteria:
- age 18 years or older
- ASA I-III
- eligible for spinal anesthetic
- able to speak
- read and understand English
- willing to participate in the trial
- will be discharged home.
Exclusion Criteria:
- contraindication to regional anesthesia
- have an allergy to local anesthetics
- contradiction to NSAID's
- have chronic pain that is not related to their knee joint
- have been using opioids on a chronic basis (3 months or longer)
- have a pre-existing peripheral neuropathy involving the operative site.
Sites / Locations
- North York General Hospital
Arms of the Study
Arm 1
Arm 2
Arm 3
Active Comparator
Active Comparator
Active Comparator
adductor-canal block and periarticular infiltration
adductor-canal block
periarticular infusion group
Adductor-canal block,performed prior to surgery using ultra sound guidance by an anesthetist, with a total of 30mL of 0.33% ropivacaine injected into the area surrounding the saphenous nerve. Periarticular infiltration, performed intra-operatively by the surgeon, involves administering a 110 mL solution of ropivacaine 300mg, preservative free morphine 10mg, ketorolac 30mg mixed in normal saline into the knee.
The adductor-canal block only group will receive an adductor-canal block prior to surgery in the block room using ultra sound guidance by an anesthetist. After the adductor-canal is located a total of 30mL of 0.33% ropivacaine will be injected into the area surrounding the saphenous nerve. Participants will also receive 110mL of normal saline administered as follows: the first 20mL aliquot is injected into the posterior capsule and the medial and lateral ligaments just prior to implantation; after the implants have been cemented and curing, another 20mL is infiltrated to the quadriceps and retinacular tissues. The remaining solution (~60mL) is used to infiltrate the muscle, subcutaneous tissues.
Periarticular infiltration,performed intra-operatively,involves administering a 110 mL solution of ropivacaine 300mg, preservative free morphine 10mg, ketorolac 30mg mixed in normal saline into the knee. It will be administered as follows: the first 20mL aliquot is injected into the posterior capsule and the medial and lateral ligaments just prior to implantation; after the implants have been cemented and curing, another 20mL is infiltrated to the quadriceps and retinacular tissues. The remaining solution (~60mL) is used to infiltrate the muscle, subcutaneous tissues.