The Role of Intra-Operative Intracapsular Blocks in Post-Operative Pain Management Following Total Knee Arthroplasty
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Purpose
The purpose of this study is to use a new combination of anesthesia techniques in an attempt to minimize early pain after surgery and improve the patient's ability to participate more fully with physical therapy. Total knee replacement patients who participate will receive the standard anesthesia. This includes a spinal nerve block as well as a femoral nerve block. The study is looking at the added benefits of including an injection of numbing medication (Bupivicaine) to the back of the knee. This injection occurs during surgery. In order to compare the outcomes we will also have a group of patients who will receive a saline injection as opposed to the numbing medication. Patients are randomly assigned to a group. Outcomes are measured up until twenty-four hours following the surgery.
| Condition | Intervention | Phase |
|---|---|---|
|
Osteoarthritis |
Other: Placebo saline injection Drug: Ropivicaine 0.5% |
Phase 4 |
| Study Type: | Interventional |
| Study Design: | Allocation: Randomized Endpoint Classification: Efficacy Study Intervention Model: Parallel Assignment Masking: Double Blind (Subject, Caregiver, Investigator, Outcomes Assessor) Primary Purpose: Supportive Care |
| Official Title: | The Role of Intra-Operative Intracapsular Blocks in Post-Operative Pain Management Following Total Knee Arthroplasty: A Double-Blinded Randomized Controlled Trial |
- Numeric Pain Score [ Time Frame: Post-anesthesia care unit (PACU), 4 hours, 8 hours, 12 hours and 24 hours post-injection ] [ Designated as safety issue: No ]Participants were asked to rate their pain on a scale of 0 to 10 at all time intervals up to 24 hours post-injection. Scores were organized into the following categories: 3 or less (mild pain), 4 to 6 (moderate pain), 7 or higher (severe pain).
- Total Fentanyl Patient-Controlled Anesthesia (PCA) Narcotic Consumption [ Time Frame: 4 hours to 24 hours post-op ] [ Designated as safety issue: No ]The PCA total dose at the 4-hour, 8-hour, 12-hour and 24-hour post-operative time points.
- Postoperative Day 1 Physical Therapy Outcome - Ambulation Distance [ Time Frame: 24 hours post-op ] [ Designated as safety issue: No ]Ambulation distance walked by participants 24-hours post-operatively
- Postoperative Day 1 Physical Therapy Outcome- Knee Extension and Flexion [ Time Frame: 24 hours post-op ] [ Designated as safety issue: No ]Knee extension and knee flexion measured at 24-hours post-operatively for patient cohort
- Postoperative Day 1 Physical Therapy Outcome - Straight Leg Raise [ Time Frame: 4 hours, 8 hours, 12 hours and 24 hours post-op ] [ Designated as safety issue: No ]Straight Leg Raise (SLR): number of people that can perform a SLR at designated intervals
| Enrollment: | 67 |
| Study Start Date: | May 2007 |
| Study Completion Date: | June 2008 |
| Primary Completion Date: | June 2008 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
|
Placebo Comparator: Block Negative
Subjects receive intra-op saline injection per protocol
|
Other: Placebo saline injection
20 cc of sterile, injectable saline
|
|
Experimental: Block Positive
Subjects receive intra-op Ropivicaine 0.5% injection per protocol
|
Drug: Ropivicaine 0.5%
Ropivicaine
Other Name: Hospiria
|
Show Detailed Description
Eligibility| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | Yes |
Inclusion Criteria:
- The subject is scheduled to undergo elective total knee replacement at Duke University Hospital.
- The subject has signed the written consent form.
Exclusion Criteria:
- Known allergy to ropivacaine or hydromorphone.
- Known history of narcotic abuse or alcohol abuse.
- Known history of chronic pain.
- Known diagnosis of peripheral neuropathy or complex regional pain syndrome.
- Significant impediment to physical therapy participation.
- The surgery is a revision case.
- Patient is undergoing bilateral Total Knee Replacement.
Contacts and Locations| United States, North Carolina | |
| Duke University Adult Reconstructive Surgery | |
| Durham, North Carolina, United States, 27710 | |
| Principal Investigator: | Michael P Bolognesi, M.D. | Duke University |
More Information
Publications:
| Responsible Party: | Duke University |
| ClinicalTrials.gov Identifier: | NCT00620828 History of Changes |
| Other Study ID Numbers: | Pro00000233, SPS# 139715 |
| Study First Received: | February 12, 2008 |
| Results First Received: | June 17, 2010 |
| Last Updated: | March 19, 2013 |
| Health Authority: | United States: Institutional Review Board |
Additional relevant MeSH terms:
|
Osteoarthritis Pain, Postoperative Arthritis Joint Diseases Musculoskeletal Diseases |
Rheumatic Diseases Postoperative Complications Pathologic Processes Pain Signs and Symptoms |
ClinicalTrials.gov processed this record on May 22, 2013