Effectiveness of a Femoral Block Following Total Knee Arthroplasty (TKA)
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Purpose
Hospital stays after total joint replacement surgery have been getting shorter over the past 10 years. This is mostly due to new ways to manage pain and early rehabilitation. To be able to go home safely soon after surgery, patients need to:
- 1) have adequate pain control
- 2) be able to move through activities of daily living on their own (using aids)
Femoral nerve block, in combination with pain medications, is one of the new treatment strategies that are currently being used at other hospitals in Canada, the United States and the United Kingdom. Nerve blocks involve a needle filled with local anesthetic into the nerve that allows the feeling of pain around the knee. With good pain management, patients will be able to more quickly bend their knee and regain the ability to walk with aids and move from sitting and lying positions to standing and walking. Once they can do these activities with adequate pain control, they can be discharged from hospital to continue recovery at home. The purpose of this study is to examine a new way of managing postoperative pain and encourage early knee flexion and mobility, while maintaining pain control for patients after total knee replacement. We believe that patients who receive the nerve block in addition to the regular pain medication will have more knee flexion at discharge and experience less pain than patients who only receive usual pain medications.
| Condition | Intervention | Phase |
|---|---|---|
|
Total Knee Arthroplasty |
Procedure: Femoral Block Other: Usual Care |
Phase 4 |
| Study Type: | Interventional |
| Study Design: | Allocation: Non-Randomized Endpoint Classification: Efficacy Study Intervention Model: Single Group Assignment Masking: Single Blind (Outcomes Assessor) Primary Purpose: Treatment |
| Official Title: | A Pilot Study of the Feasibility of Early Discharge After Total Knee Arthroplasty Using a Femoral Nerve Block |
- knee flexion [ Time Frame: at hospital discharge or day 4 postoperatively, whichever is earlier ] [ Designated as safety issue: No ]
- pain [ Time Frame: daily in hospital, 2 weeks, 6 weeks, 12 weeks ] [ Designated as safety issue: No ]
- length of hospital stay [ Time Frame: during hospitalization ] [ Designated as safety issue: No ]
- nausea/vomiting [ Time Frame: during hospitalization ] [ Designated as safety issue: No ]
- participation in rehabilitation [ Time Frame: day of surgery ] [ Designated as safety issue: No ]
| Enrollment: | 20 |
| Study Start Date: | April 2008 |
| Study Completion Date: | December 2009 |
| Primary Completion Date: | October 2009 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
|
Experimental: Femoral Block
Those receiving femoral block in addition to usual pain management
|
Procedure: Femoral Block
Those receiving femoral block postoperatively
|
|
No Intervention: Usual Care
Those receiving only usual pain management without a femoral block
|
Other: Usual Care
Those receiving only usual pain management postoperatively
|
Eligibility| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- Undergoing primary total knee arthroplasty
- English-speaking
- Preoperative knee ROM > 90 degrees
- Body Mass Index < 40
Exclusion Criteria:
- Regular preoperative opioid use
- Hepatic insufficiency
- Any contra-indications to receiving a femoral block
Contacts and Locations
More Information
No publications provided
| Responsible Party: | Tsui, Ban; Pediatric and Adult Anesthesiologist, Associate Professor/Director of Clinical Research,, Stollery Children's Hospital/University of Alberta Hospital, |
| ClinicalTrials.gov Identifier: | NCT00659087 History of Changes |
| Other Study ID Numbers: | J-3224 |
| Study First Received: | April 10, 2008 |
| Last Updated: | June 21, 2011 |
| Health Authority: | Canada: Ethics Review Committee |
Keywords provided by Edmonton Civic Employees Research Fund:
|
Total Knee Range of Motion Pain |
ClinicalTrials.gov processed this record on May 16, 2013