Phase 4
N=114
Effects of Catheter Location on Postoperative Analgesia for Continuous Adductor Canal and Popliteal-Sciatic Nerve Blocks
Post-surgical Pain · Total Knee Arthroplasty · Foot/Ankle Surgery · Catheterization for Postop Analgesia
Bottom Line
View on ClinicalTrials.gov: NCT02523235 ↗Enrolled (actual)
114
Serious AEs
0.0%
Results posted
Sep 2019
Primary outcome: Primary: Pain (Average): Numeric Rating Scale for Pain — 0.5; 3.0 score on a scale
Study Design & Population
- Study type
- Interventional
- Phase
- Phase 4
- Interventions
- ropivacaine 0.2% (Drug)
- Age
- Adult, Older Adult · 18+ yrs
- Sex
- All
- Sponsor
- University of California, San Diego
- Primary completion
- Feb 2018
Outcome Measures
| Outcome | Result | p-value |
|---|---|---|
| PRIMARY Pain (Average): Numeric Rating Scale for Pain |
0.5; 3.0 | — |
| SECONDARY Pain (Worst) :Numeric Rating Scale for Pain |
4.0; 5.0 | — |
| SECONDARY Analgesic Use: IV Morphine Equivalents |
6.7; 6.7 | — |
| SECONDARY Ambulation: Distance in Meters |
150; 170 | — |
| SECONDARY Pain During Afternoon Physical Therapy Session |
3.0; 3.0 | — |
| SECONDARY Number of Participants That Had Fluid Leakage Reported at Catheter Site. |
3; 1 | — |
| SECONDARY Toe/Foot Numbness (Insensate) :0-10 Scale |
7.0; 7.0 | — |
| SECONDARY Total Local Anesthetic Infused (Adductor Only) : mL |
32; 40 | — |
Summary
Currently, continuous adductor canal and popliteal-sciatic nerve blocks are used commonly for lower extremity post-operative pain control, specifically for total knee arthroplasty and foot/ankle surgery, respectively. A perineural catheter used to infuse local anesthetic for postoperative analgesia may be placed at various locations along the target nerves. Investigations of single-injection peripheral nerve blocks suggest that the onset of the block might be faster with one location over the other; but, the success rates are equivalent. However, remaining unknown is whether there is an optimal location to place a perineural catheter as part of a continuous peripheral nerve block.
Eligibility Criteria
Inclusion Criteria
- undergoing surgery with an adductor canal or popliteal-sciatic perineural catheter for postoperative analgesia following primary tri-compartment knee arthroplasty or foot/ankle surgery;
- anticipated to have at least moderate pain following surgery [NRS>3]; and,
- age 18 years or older.
Exclusion Criteria
- pregnancy (a urine pregnancy test is standard at UCSD for female patients prior to menopause who are sexually active with the opposite sex within the previous year);
- inability to communicate with the investigators and hospital staff;
- clinical neuropathy in the surgical extremity;
- chronic high-dose opioid use (defined as daily use for more than 4 weeks prior to surgery of at least the equivalent of 20 mg oxycodone);
- BMI > 40 kg/m2;
- allergy to study medications (lidocaine, ropivicaine);
- known renal insufficiency; or,
- incarceration.
Data sourced from ClinicalTrials.gov (NCT02523235). Outcome figures and adverse-event rates are extracted automatically from the registry's posted results and are provided for clinician reference, not as a substitute for the primary publication.