LIA vs. LIA + ACB-iPACK Block for Total Knee Arthroplasty

Launched by WOMEN'S COLLEGE HOSPITAL · Mar 18, 2021

Keywords

ClinConnect Summary

This clinical trial is studying two different methods of pain relief for patients undergoing total knee replacement surgery, also known as knee arthroplasty. The main method being tested is called Local Infiltration Analgesia (LIA), which is a common approach to manage pain after surgery. The researchers want to find out if adding two additional nerve blocks, called ACB and iPACK, to the LIA can provide better pain relief than LIA alone.

To participate in this trial, you should be between the ages of 18 and 85, in generally good health (classified as ASA I-III), and planning to have a single knee replacement surgery. However, some patients may not be eligible if they have certain health conditions, like serious heart or lung problems, or if they have had previous surgeries on both knees. If you join the study, you’ll receive either the standard pain relief treatment or the combination treatment, and the team will monitor your pain levels and recovery process. This trial is not yet recruiting participants, but it aims to help improve pain management for future knee surgery patients.

Gender

ALL

Eligibility criteria

• Inclusion Criteria:
• • 1. ASA classification I-III
• • 2. BMI \< 35 kg/m2
• • 3. Having elective unilateral total knee arthroplasty
• Exclusion Criteria:
• • 1. Bilateral knee surgery.
• • 2. Pre-existing neurological deficit or peripheral neuropathy in the lower the lower limbs
• • 3. Severe, poorly controlled cardiac conditions, significant arrhythmias, severe valvular heart diseases
• • 4. Severe, poorly controlled respiratory conditions (severe COPD, severe interstitial lung disease, severe / poorly controlled asthma)
• • 5. Contraindication to regional anesthesia (e.g. bleeding diathesis, coagulopathy, sepsis, infection at the site of potential needle puncture on the posterior chest)
• • 6. Patient refusal
• • 7. Chronic pain disorder
• • 8. Chronic opioid use (≥30 mg oxycodone / day)
• • 9. Contraindication (or allergy) to a component of multi-modal analgesia protocol
• • 10. Allergy to amide local anesthetics used in nerve blocks
• • 11. Contraindications to spinal anesthesia
• • 12. Significant psychiatric disorder that would preclude objective study assessment
• • 13. Pregnancy
• • 14. Inability to provide informed consent