Phase 3
N=94
Adductor Canal Block Versus Femoral Nerve Block for Total Knee Arthroplasty
Arthropathy of Knee
Bottom Line
View on ClinicalTrials.gov: NCT03133481 ↗Enrolled (actual)
94
Serious AEs
0.0%
Results posted
Jan 2019
Primary outcome: Primary: Mean Distance Ambulated at 24 Hours Post Operatively — 70.2; 48.44 feet
Study Design & Population
- Study type
- Interventional
- Phase
- Phase 3
- Interventions
- Adductor Canal Nerve Block (Procedure); Femoral Nerve Block (Drug)
- Age
- Adult, Older Adult · 19+ yrs
- Sex
- All
- Sponsor
- University of Alabama at Birmingham
- Primary completion
- Oct 2017
Outcome Measures
| Outcome | Result | p-value |
|---|---|---|
| PRIMARY Mean Distance Ambulated at 24 Hours Post Operatively |
70.2; 48.44 | — |
| PRIMARY Mean Distance Ambulated at 48 Hours Post Operatively |
129.02; 106.38 | — |
| SECONDARY Mean Pain Scores Immediately Preoperatively |
3.07; 3.38 | — |
| SECONDARY Mean Opioid Consumption as Measured by Oral Morphine Milligram Equivalents |
23; 22.33 | — |
| SECONDARY Patient Satisfaction at 48 Hours Post Operatively |
8.71; 9.24 | — |
| SECONDARY Mean Hours to Discharge |
89.66; 83.78 | — |
| SECONDARY Mean Pain Scores in PACU |
3.91; 2.98 | — |
| SECONDARY Mean Pain Scores at 24 Hours |
4.18; 4 | — |
| SECONDARY Mean Pain Scores 48 Hours Postoperatively |
4.53; 4.44 | — |
| SECONDARY Mean Opioid Consumption as Measured in Oral Morphine Milligram Equivalents |
75.54; 68.78 | — |
| SECONDARY Mean Opioid Consumption as Measured in Oral Morphine Milligram Equivalents |
75.54; 68.78 | — |
| SECONDARY Mean Opioid Consumption as Measured in Oral Morphine Equivalents |
55.49; 44.47 | — |
Summary
Peripheral nerve blocks catheters of the femoral nerve have long been used for perioperative analgesia in total knee arthroplasty (TKA). These blocks provide effective analgesia and patient satisfaction for surgical pain relief. However, one of the main drawbacks to the femoral nerve block (FNB) is a denser motor block of the quadriceps muscle that can delay aggressive physical therapy and subsequent recovery from surgery. (1) Recently, there has been increasing interest in performing adductor canal blocks (ACB) with the aim of less motor blockade while providing commensurate analgesia compared to the FNB. (1,2) Current investigative reports have provided only preliminary data, and there is potential to change the standard of care for TKA as more data mounts in favor of ACBs. The goal of this study is to verify the analgesic equivalence of the two blocks, compare patient satisfaction, surgeon satisfaction, and physical therapy grading between the two blocks. Potentially, this would change the standard of care for TKA patients at this institution.
Eligibility Criteria
Inclusion Criteria
- Patient undergoing total knee arthroplasty with regional anesthesia planned for postoperative analgesia.
- Adult, 19 years of age or older
- Patient classified as American Society of Anesthesiology (ASA) class I, II, or III
Exclusion Criteria
- Any subject not classified as an ASA I, II, or III
- Allergy/intolerance to local anesthetic
- Pre-existing neurologic or anatomic deficit in lower extremity on the side of the surgical site
- Coexisting coagulopathy such as hemophilia or von Willebrand disease
Data sourced from ClinicalTrials.gov (NCT03133481). 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.