Single Shot Versus Continuous Adductor Canal Block in Patients Undergoing Total Knee Arthroplasty
Rheumatism Knee
About this trial
This is an interventional treatment trial for Rheumatism Knee
Eligibility Criteria
Inclusion Criteria:
- Patients scheduled for primary total knee arthroplasty with
- American Society of Anesthesiologists (ASA) physical status I -III,
- mentally competent and able to give consent for enrollment in the study.
Exclusion Criteria:
- Patient younger than 18 years old or older than 70 years old
- Allergy to local anesthetics, systemic opioids (fentanyl, morphine, hydromorphone, and any of the drugs included in the multimodal perioperative pain protocol.
- Revision surgeries were excluded.
- Impaired kidney functions and patients with coagulopathy were also excluded.
- Chronic pain syndromes and patients with chronic opioid use defined as the use of regular daily doses of systemic narcotics for the past 6 months prior to the surgery.
- BMI of 40 or more
- Pregnancy (positive urine pregnancy test result in Preop area on the morning of surgery)
Sites / Locations
- Aswan University Hospital
- Huda Fahmy
Arms of the Study
Arm 1
Arm 2
Active Comparator
Active Comparator
Single shot adductor canal block
Continuous adductor canal block
Following sterile preparation and draping, an ultrasound survey of the medial thigh was performed, halfway between the superior anterior iliac spine and the patella. The superficial femoral artery has been identified beneath the sartorius muscle in a short-axis view, with the vein just inferior and the saphenous nerve just lateral to the artery. A 20 Gauge, 120 mm, non-cuttings tip echogenic needle (SonoPlex STIM, Germany) needle was introduced in-plane, and 2 to 3 mL of LA bolus (0.25 % Bupivacaine) was used to confirm proper needle placement in the adductor canal near the saphenous nerve. Then, a bolus of 20 ml of Bupivacaine 0.25 % was injected through the needle
a catheter was secured in place using Tegaderm. The catheters were connected to a pump that infused local anesthetic, 20 mL of 0.25 % bupivacaine, followed by 48 hours of continuous infusion of 0.125 % bupivacaine at 5 mL/h.