Management of Postoperative Pain After Total Knee Replacement.
Summary
The purpose of this study is to compare two methods of postoperative pain management in patients undergoing total knee replacement.
Description
Patients undergoing total knee replacement will be assigned at random to receive one of two methods of postoperative pain management. Patients assigned to nerve block will receive regional anesthetic nerve block using an indwelling femoral nerve catheter and a single shot sciatic nerve block. Patients assigned to periarticular injection will receive periarticular local injection into the periarticular soft tissues at the time of knee replacement using a combination of ropivacaine, epinephrine, ketorolac, and morphine sulphate. Additionally, all patients will be given a standardized combination of oral analgesic medications preoperatively and postoperatively. All patients will receive a posterior stabilized total knee replacement through an medial parapatellar approach.
Study Design
Allocation: Randomized, Control: Active Control, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Treatment
Conditions
Postoperative Pain
Intervention
Nerve Block, Periarticular Injection
Location
Mayo Clinic
Phoenix
Arizona
United States
Status
Recruiting
Source
Mayo Clinic
Results (where available)
Links
- Source: http://clinicaltrials.gov/show/NCT01163214
- Information obtained from ClinicalTrials.gov on July 15, 2010
Published on BioPortfolio: 2014-08-27T03:12:11-0400
Clinical Trials
A comparison of two pain control methods - the combination of Adductor Canal Block (ACB)/Periarticular Injection (PAI)/Infiltration of the interspace between the popliteal artery and the c...
Peripheral Nerve Blocks vs Periarticular Local Anesthetic Injection for TKA
The purpose of this study is to evaluate the hypothesis that the investigators current total joint regional anesthesia pathway of continuous femoral nerve block plus single-injection sciat...
Postoperative Pain After Volar Plating for Distal Radius Fractures
The investigators undertook to evaluate early postoperative pain levels after the volar plating of distal radius fractures performed under regional anesthesia, and to determine whether per...
This is a randomized, double blinded, standard of care controlled clinical trial. All adult patients over eighteen desiring total knee arthroplasty will be eligible. The study compares pai...
Periarticular Multimodal Drug Injections in Total Knee Arthroplasty
The purpose of this study is to determine whether periarticular multimodal drug injection (PMDI) would provide additional benefits in patients after TKA for whom contemporary pain control ...
PubMed Articles
Periarticular injections (PAIs) are becoming a staple component of multimodal joint pathways. Motor-sparing peripheral nerve blocks, such as the infiltration between the popliteal artery and capsule o...
Periarticular analgesic injection (PAI) is being used more commonly for pain relief after orthopaedic surgeries. However, there is conflicting evidence regarding the effectiveness of PAI for post-THA ...
The speed of local anesthetic (LA) injections in peripheral regional anesthesia ranges from slow continuous infusions (3-12 mL/h) to rapid manual injections (>7500 mL/h). Optimizing injection speed co...
A Randomized Controlled Trial of Liposomal Bupivacaine Parasternal Intercostal Block For Sternotomy.
Optimal pain control continues to be a concern in cardiac surgery. Current strategies for postoperative pain management often yield suboptimal results. The superiority of Exparel in providing postoper...
Hip surgery is a major surgery that causes severe postoperative pain. Although pain during rest is usually considerably reduced mobilization is important in terms of thromboembolic complications. The ...
Medical and Biotech [MESH] Definitions
Autonomic Nerve Block
Interruption of sympathetic pathways, by local injection of an anesthetic agent, at any of four levels: peripheral nerve block, sympathetic ganglion block, extradural block, and subarachnoid block.
Nerve Block
Interruption of the conduction of impulses in peripheral nerves or nerve trunks by the injection of a local anesthetic solution. (Stedman, 26th ed)
Etodolac
A nonsteroidal anti-inflammatory agent with potent analgesic and antiarthritic properties. It has been shown to be effective in the treatment of OSTEOARTHRITIS; RHEUMATOID ARTHRITIS; ankylosing SPONDYLITIS; and in the alleviation of postoperative pain (PAIN, POSTOPERATIVE).
Pain, Postoperative
Pain during the period after surgery.
Meperidine
A narcotic analgesic that can be used for the relief of most types of moderate to severe pain, including postoperative pain and the pain of labor. Prolonged use may lead to dependence of the morphine type; withdrawal symptoms appear more rapidly than with morphine and are of shorter duration.
