Optimizing Local Anesthetic Concentration for Continuous Femoral Nerve Blocks
- Full Text View
- Tabular View
- No Study Results Posted
- Disclaimer
- How to Read a Study Record
Purpose
This is a randomized, observer-masked, controlled study. Subjects will be patients undergoing bilateral total knee arthroplasty (TKA). One side (left or right) will be randomized to one of two treatment groups: a postoperative ropivacaine concentration of 0.1% or 0.4%. The contralateral side will receive the other possible ropivacaine concentration of 0.1% or 0.4%. The basal rate and patient-controlled bolus volume will depend upon the treatment group, but the total dose of local anesthetic is the same for each. For the duration of the study, all patients will receive the current usual and customary analgesics for bilateral TKA patients. All patients will receive a ropivacaine perineural infusions initiated in the operating room and continued until at least the afternoon of postoperative day (POD) 2, as well as oral acetaminophen, a sustained-release oral opioid; and celecoxib. Rescue opioid and route of administration will be determined by pain severity using a Numeric Rating Scale of 0-10, with 0 equal to no pain and 10 being the worst imaginable pain.
| Condition | Intervention | Phase |
|---|---|---|
|
Total Knee Arthroplasty Knee Pain |
Drug: 0.1% and 0.4% perineural ropivicaine |
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: Treatment |
| Official Title: | Optimizing Local Anesthetic Concentration for Continuous Femoral Nerve Blocks |
- Quadriceps femoris muscle strength maximum voluntary isometric contraction (MVIC) [ Time Frame: morning of postoperative day 2 ] [ Designated as safety issue: No ]
| Enrollment: | 48 |
| Study Start Date: | June 2009 |
| Study Completion Date: | April 2011 |
| Primary Completion Date: | April 2011 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
|
Active Comparator: 1) 0.1% Ropivicaine on Right Leg
Patients will be randomized ot 0.1% Ropivicaine infusion on the right leg and therefore 0.4% Ropivicain in fusion for the left leg for pain due to bilateral TKA. The outcome measures will be measured on both legs, starting with the right leg each time. The infusion will last for the two days following surgery, that the patient is staying in the hospital.
|
Drug: 0.1% and 0.4% perineural ropivicaine
Patients will be randomized to one of two groups: Ropivicaine 0.1% infusion on the right leg and Ropivicaine 0.4% infusion on the left leg, or Ropivicaine 0.4% infusion on the right leg and Ropiviciane 0.1% infusion on the left leg for treatment of postoperative pain following bilateral TKA. Both groups will receive the same total dose of medication and will have the infusion for the two days following surgery.
|
|
Active Comparator: 2) 0.4% Ropivicaine on Right Leg
Patients will be randomized ot 0.4% Ropivicaine infusion on the right leg and therefore 0.1% Ropivicain in fusion for the left leg for pain due to bilateral TKA. The outcome measures will be measured on both legs, starting with the right leg each time. The infusion will last for the two days following surgery, that the patient is staying in the hospital.
|
Drug: 0.1% and 0.4% perineural ropivicaine
Patients will be randomized to one of two groups: Ropivicaine 0.1% infusion on the right leg and Ropivicaine 0.4% infusion on the left leg, or Ropivicaine 0.4% infusion on the right leg and Ropiviciane 0.1% infusion on the left leg for treatment of postoperative pain following bilateral TKA. Both groups will receive the same total dose of medication and will have the infusion for the two days following surgery.
|
Detailed Description:
The investigators propose to test the null hypothesis that differing concentrations of ropivacaine (0.1% vs. 0.4%) at an equal total dose has no impact on quadriceps muscle strength during a continuous femoral nerve block following total knee arthroplasty (TKA). These results will help define the optimal concentration of local anesthetic used for continuous peripheral nerve blocks.
Eligibility| Ages Eligible for Study: | 18 Years and older |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- Primary, bilateral TKA
- Age 18 years or older
- Postoperative analgesic pain includes bilateral continuous femoral nerve blocks
Exclusion Criteria:
- Chronic, high-dose opioid use
- History of opioid abuse
- Any neuro-muscular deficit of either femoral nerves and/or quadriceps muscles
- Pregnancy
- Incarceration
Contacts and Locations| United States, Ohio | |
| The Cleveland Clinic, Main Campus | |
| Cleveland, Ohio, United States, 44195 | |
| Principal Investigator: | Daniel I Sessler, M.D. | The Cleveland Clinic, Chair, Department of Outcomes Research |
More Information
No publications provided
| Responsible Party: | Brian M. Ilfeld, MD, MS, Associate Professor, In Residence, University of California, San Diego |
| ClinicalTrials.gov Identifier: | NCT00923598 History of Changes |
| Other Study ID Numbers: | Cleveland TKA Study |
| Study First Received: | June 17, 2009 |
| Last Updated: | June 12, 2012 |
| Health Authority: | United States: Institutional Review Board |
Keywords provided by University of California, San Diego:
|
TKA Bilateral Cleveland Clinic UCSD Catheter |
Nerve block Postoperative pain Femoral Catheter Bilateral Total Knee Arthroplasty Bilateral Femoral Catheter |
Additional relevant MeSH terms:
|
Anesthetics, Local Anesthetics Central Nervous System Depressants Physiological Effects of Drugs Pharmacologic Actions |
Sensory System Agents Peripheral Nervous System Agents Central Nervous System Agents Therapeutic Uses |
ClinicalTrials.gov processed this record on May 23, 2013