Femoral/Sciatic Block for Knee Surgery
Primary Purpose
Knee Injuries
Status
Completed
Phase
Not Applicable
Locations
Study Type
Interventional
Intervention
femoral nerve blockade
morphine
Sponsored by
About this trial
This is an interventional treatment trial for Knee Injuries focused on measuring Analgesia, Nerve Block, Pain, Postoperative
Eligibility Criteria
Inclusion Criteria:
- Patients aged over 18 years old, American Society of Anesthesiologists (ASA) physical status from I to III who underwent total knee arthroplasty
Exclusion Criteria:
- Patients aged below 18 years old, ASA IV or V physical status, infection near the puncture site, coagulation disorders, preexisting neurological disorders, allergy report to local anesthetics, pregnancy and lactation, contraindications to spinal block and refusal to sign an informed consent form
Sites / Locations
Arms of the Study
Arm 1
Arm 2
Arm Type
Experimental
Active Comparator
Arm Label
femoral blockade
Morphine
Arm Description
femoral nerve blockade followed by a catheter placement for continuous infusion and a "single shot" block of the sciatic nerve
intrathecal morphine
Outcomes
Primary Outcome Measures
Analgesic Efficacy
Pain with verbal numeric rating scale (VNRS). VNRS has 11 points, from zero to 10 (zero= no pain, 1-3 = mild pain, 4-5 = moderate pain, 7-9 = severe pain, 10 = unbearable pain).
Secondary Outcome Measures
Postoperative Bleeding
Postoperative bleeding volume (ml)
Full Information
NCT ID
NCT02882152
First Posted
August 24, 2016
Last Updated
December 23, 2016
Sponsor
University of Sao Paulo General Hospital
1. Study Identification
Unique Protocol Identification Number
NCT02882152
Brief Title
Femoral/Sciatic Block for Knee Surgery
Official Title
Continuous Femoral Nerve Blockade and Single Shot Sciatic Nerve Block Compared to Intrathecal Morphine for Total Knee Arthroplasty
Study Type
Interventional
2. Study Status
Record Verification Date
September 2014
Overall Recruitment Status
Completed
Study Start Date
August 2011 (undefined)
Primary Completion Date
September 2014 (Actual)
Study Completion Date
September 2014 (Actual)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Sponsor
Name of the Sponsor
University of Sao Paulo General Hospital
4. Oversight
Data Monitoring Committee
No
5. Study Description
Brief Summary
Knee arthroplasty has a high potential for postoperative pain. This study compares analgesia and postoperative bleeding from intrathecal morphine with the continuous femoral and a single-shot sciatic nerve blockades.
Detailed Description
This study aims to compare intrathecal morphine as a technique for analgesia with the femoral nerve blockade associated with a single-shot sciatic nerve blockade. Analgesic efficacy, the incidence of adverse effects, and postoperative bleeding were evaluated
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Knee Injuries
Keywords
Analgesia, Nerve Block, Pain, Postoperative
7. Study Design
Primary Purpose
Treatment
Study Phase
Not Applicable
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Randomized
Enrollment
40 (Actual)
8. Arms, Groups, and Interventions
Arm Title
femoral blockade
Arm Type
Experimental
Arm Description
femoral nerve blockade followed by a catheter placement for continuous infusion and a "single shot" block of the sciatic nerve
Arm Title
Morphine
Arm Type
Active Comparator
Arm Description
intrathecal morphine
Intervention Type
Procedure
Intervention Name(s)
femoral nerve blockade
Intervention Description
femoral nerve blockade followed by a catheter placement for continuous infusion and a "single shot" block of the sciatic nerve at the end of the surgery
Intervention Type
Procedure
Intervention Name(s)
morphine
Intervention Description
Intrathecal morphine injection
Primary Outcome Measure Information:
Title
Analgesic Efficacy
Description
Pain with verbal numeric rating scale (VNRS). VNRS has 11 points, from zero to 10 (zero= no pain, 1-3 = mild pain, 4-5 = moderate pain, 7-9 = severe pain, 10 = unbearable pain).
Time Frame
baseline (zero hour: discharge of post-anesthesia care unit-PACU), 24hs, 48hs, 72 hours
Secondary Outcome Measure Information:
Title
Postoperative Bleeding
Description
Postoperative bleeding volume (ml)
Time Frame
baseline (discharge of post-anesthesia care unit-PACU), 24hs, 48hs, 72 hours
10. Eligibility
Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
Accepts Healthy Volunteers
Eligibility Criteria
Inclusion Criteria:
Patients aged over 18 years old, American Society of Anesthesiologists (ASA) physical status from I to III who underwent total knee arthroplasty
Exclusion Criteria:
Patients aged below 18 years old, ASA IV or V physical status, infection near the puncture site, coagulation disorders, preexisting neurological disorders, allergy report to local anesthetics, pregnancy and lactation, contraindications to spinal block and refusal to sign an informed consent form
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Alfredo J Mansur, MD. PhD
Organizational Affiliation
Comissão de Ética para Análise de Projetos de Pesquisa-CAPPesq - HCFMUSP
Official's Role
Study Director
12. IPD Sharing Statement
Plan to Share IPD
No
Citations:
PubMed Identifier
25111605
Citation
Bauer MC, Pogatzki-Zahn EM, Zahn PK. Regional analgesia techniques for total knee replacement. Curr Opin Anaesthesiol. 2014 Oct;27(5):501-6. doi: 10.1097/ACO.0000000000000115.
Results Reference
background
PubMed Identifier
26731032
Citation
Guay J, Kopp S. Epidural pain relief versus systemic opioid-based pain relief for abdominal aortic surgery. Cochrane Database Syst Rev. 2016 Jan 5;2016(1):CD005059. doi: 10.1002/14651858.CD005059.pub4.
Results Reference
background
PubMed Identifier
22798178
Citation
Bujedo BM, Santos SG, Azpiazu AU. A review of epidural and intrathecal opioids used in the management of postoperative pain. J Opioid Manag. 2012 May-Jun;8(3):177-92. doi: 10.5055/jom.2012.0114.
Results Reference
background
PubMed Identifier
19462494
Citation
Gehling M, Tryba M. Risks and side-effects of intrathecal morphine combined with spinal anaesthesia: a meta-analysis. Anaesthesia. 2009 Jun;64(6):643-51. doi: 10.1111/j.1365-2044.2008.05817.x.
Results Reference
background
PubMed Identifier
27370542
Citation
Li XM, Huang CM, Zhong CF. Intrathecal morphine verse femoral nerve block for pain control in total knee arthroplasty: A meta-analysis from randomized control trials. Int J Surg. 2016 Aug;32:89-98. doi: 10.1016/j.ijsu.2016.06.043. Epub 2016 Jul 6.
Results Reference
background
PubMed Identifier
19388886
Citation
Kadic L, Boonstra MC, DE Waal Malefijt MC, Lako SJ, VAN Egmond J, Driessen JJ. Continuous femoral nerve block after total knee arthroplasty? Acta Anaesthesiol Scand. 2009 Aug;53(7):914-20. doi: 10.1111/j.1399-6576.2009.01965.x. Epub 2009 Apr 15.
Results Reference
background
PubMed Identifier
27469381
Citation
Grape S, Kirkham KR, Baeriswyl M, Albrecht E. The analgesic efficacy of sciatic nerve block in addition to femoral nerve block in patients undergoing total knee arthroplasty: a systematic review and meta-analysis. Anaesthesia. 2016 Oct;71(10):1198-209. doi: 10.1111/anae.13568. Epub 2016 Jul 29.
Results Reference
background
PubMed Identifier
1170786
Citation
Raj PP, Parks RI, Watson TD, Jenkins MT. A new single-position supine approach to sciatic-femoral nerve block. Anesth Analg. 1975 Jul-Aug;54(4):489-93. doi: 10.1213/00000539-197507000-00020.
Results Reference
background
PubMed Identifier
28499420
Citation
Alvarez NER, Ledesma RJG, Hamaji A, Hamaji MWM, Vieira JE. Continuous femoral nerve blockade and single-shot sciatic nerve block promotes better analgesia and lower bleeding for total knee arthroplasty compared to intrathecal morphine: a randomized trial. BMC Anesthesiol. 2017 May 12;17(1):64. doi: 10.1186/s12871-017-0355-x.
Results Reference
derived
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Femoral/Sciatic Block for Knee Surgery
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