BLOCK-study: Better Local Orthopedic Pain Control After Knee Arthroplasty

Launched by JESSA HOSPITAL · Dec 20, 2024

Keywords

ClinConnect Summary

The BLOCK study is looking to improve pain control for patients undergoing knee replacement surgery, also known as total knee arthroplasty (TKA). Researchers want to compare two methods of anesthesia: one called iPACK combined with a femoral triangle block, and another called surgical local infiltration analgesia (LIA). They believe that the first method may be just as effective as the second, while potentially reducing the risk of nerve damage and other complications.

To participate in this study, you should be between 65 and 74 years old, have a body mass index (BMI) between 17 and 35, and be able to understand and sign consent forms. You must also be scheduled for knee replacement surgery. However, some people may not be eligible if they have certain medical conditions, take specific medications, or have had previous complications related to pain management. If you join the study, you will receive one of the two anesthesia methods, and the research team will monitor your pain levels and recovery process closely. This is an important step towards finding better pain control options after knee surgery!

Gender

ALL

Eligibility criteria

• Inclusion Criteria:
• • ASA I-III
• • BMI 17-35 kg/m2
• • Patient is able to give informed consent
• • Patient is scheduled for TKA
• Exclusion Criteria:
• • Refusal of patient
• • Inability to communicate due to language or neurologic barriers
• • Bilateral TKA or unilateral knee arthroplasty
• * Chronic opioid use (including partial opioid agonists) + chronic pain patients:
• • Use of atypical analgesics (gabapentin, pregabalin, ...)
• • History of Sudeck atrophy
• • History of \>3 chronic pain consultations
• • Contraindications for spinal anesthesia
• • Patient refusal
• • Local infection
• • Aberrant coagulation (according to the latest ESRA guidelines)
• • Severe spinal canal stenosis
• • Intracranial hypertension
• • History of neurological injury in the affected limb
• • Contraindications for local anesthetics
• • Allergy for local anesthetics
• • Absolute contraindications for NSAIDs or paracetamol
• • Proven allergy for NSAID's (including ASA syndrome) or paracetamol
• • Severe renal function impairment (eGFR \<30 ml/min/1.73 m2)
• • Active or recent (\<6 months) history of gastric ulcera/perforations/bleeding
• • Crohn disease or colitis ulcerosa
• • Liver function impairment or severe renal function impairment (eGFR \<30 ml/min/1.73 m2)
• • Pregnancy or breast-feeding