Adductor Canal Block Versus Femoral Nerve Block for Analgesia After Anterior Cruciate Ligament Reconstruction Arthroscopically

• ClinicalTrials.gov Identifier: NCT02355093
• Recruitment Status: Unknown
• First Posted: February 4, 2015
• Last Update Posted: February 4, 2015
• Sponsor: Shanghai Jiao Tong University Affiliated Sixth People's Hospital
• Information provided by (Responsible Party): Daqiang Zhao, Shanghai Jiao Tong University Affiliated Sixth People's Hospital

Study Description

Brief Summary:

This study aims to compare continuous femoral nerve block with adductor canal block after anterior cruciate ligament reconstruction arthroscopically，especially in the effect on quadriceps strength; and to evaluate which regional anesthesia is more ideal for the patients postoperatively.

Condition or disease	Intervention/treatment	Phase
Anesthesia; Reaction	Procedure: adductor canal block (ACB); Procedure: Femoral nerve block (FNB); Drug: ropivacaine	Phase 4

Detailed Description:

Forty patients with American Society of Anesthesiologists（ASA） Ⅰ-Ⅲ（no limitation of age and gender）are randomized to receive either a continuous adductor canal block(ACB) or a femoral nerve block(FNB) via a catheter (a continuous infusion of 0.2% ropivacaine, 5 mL/h for 48 hours)in the PACU immediately after the anterior cruciate ligament reconstruction arthroscopically. Patients were under general anesthesia during the operation and received a femoral nerve block with 0.25% ropivacaine 10ml before the surgery.Both groups will receive postoperatively IV patient controlled analgesia (PCA) with morphine (bolus 0.8mg,lock-out time 15 minutes, background infusion 2ml/h)beside the continuous nerve block. Patients are going to be visited for follow-up on the day of surgery and in the following two days. Quadriceps strength is assessed with the displacement of patella.VAS at rest time、degree of knee flexion、VAS at 45°flexion of the knee、dose of opioids、whether the patient has sleep disturbance are also recorded.

Study Design

• Study Type: Interventional (Clinical Trial)
• Estimated Enrollment: 40 participants
• Allocation: Randomized
• Intervention Model: Parallel Assignment
• Masking: Single (Participant)
• Primary Purpose: Treatment
• Official Title: Adductor Canal Block Versus Femoral Nerve Block for Analgesia After Anterior Cruciate Ligament Reconstruction Arthroscopically
• Study Start Date: July 2014
• Estimated Primary Completion Date: March 2015
• Estimated Study Completion Date: October 2015

Arms and Interventions

Arm	Intervention/treatment
Experimental: adductor canal block (ACB); We performed an ultrasound survey at the medial part of the thigh，the needle is introduced in-plane and 2 to 3 mL of saline is used to ensure correct placement of the needle in the vicinity of the saphenous nerve in the adductor canal,the catheter is introduced and advanced 1 to 2 cm beyond the tip of the needle.The study medication is administered as an infusion of 0.2% ropivacaine at a rate of 5mL/h during the next 48 hours.	Procedure: adductor canal block (ACB); We performed an ultrasound survey at the medial part of the thigh，the needle is introduced in-plane and 2 to 3 mL of saline is used to ensure correct placement of the needle in the vicinity of the saphenous nerve in the adductor canal,the catheter is introduced and advanced 1 to 2 cm beyond the tip of the needle.The study medication is administered as an infusion of 0.2% ropivacaine at a rate of 5mL/h during the next 48 hours.; Drug: ropivacaine
Active Comparator: Femoral nerve block (FNB); the catheter is inserted in-plane with the probe parallel to the inguinal crease, to obtain a short-axis view of the nerve. The correct needle placement is confirmed by injecting 2 to 3 mL of saline to cause tissue expansion below the iliac fascia, lateral to the femoral artery, and in the vicinity of the femoral nerve. The catheter is introduced 1 to 2 cm beyond the tip of the needle，an infusion of 0.2% ropivacaine at a rate of 5mL/h is administered during the next 48 hours.	Procedure: Femoral nerve block (FNB); the catheter is inserted in-plane with the probe parallel to the inguinal crease, to obtain a short-axis view of the nerve. The correct needle placement is confirmed by injecting 2 to 3 mL of saline to cause tissue expansion below the iliac fascia, lateral to the femoral artery, and in the vicinity of the femoral nerve. The catheter is introduced 1 to 2 cm beyond the tip of the needle，an infusion of 0.2% ropivacaine at a rate of 5mL/h is administered during the next 48 hours.; Drug: ropivacaine

Outcome Measures

Primary Outcome Measures :

1. quadriceps muscle strength, as measured by handheld dynamometer. [ Time Frame: 3 days ]

Secondary Outcome Measures :

1. pain at rest time and during flexion of the knee, as measured by visual analog score(VAS). [ Time Frame: 3 days ]

Other Outcome Measures:

1. Dose of opioids [ Time Frame: 3 days ]

Eligibility Criteria

• Ages Eligible for Study: Child, Adult, Older Adult
• Sexes Eligible for Study: All
• Accepts Healthy Volunteers: No

Criteria

Inclusion Criteria:

• ASA Ⅰ-Ⅲ
• Anterior Cruciate Ligament Reconstruction

Exclusion Criteria:

• patient refusal
• chronic use of opioids
• coagulation disorders
• infection at the puncture site
• allergic to anaesthetic
• preexisting neurological disorders
• communication difficulties

Contacts and Locations

Sponsors and Collaborators

Shanghai Jiao Tong University Affiliated Sixth People's Hospital

Investigators

• Principal Investigator: Daqiang Zhao, Master; Shanghai Jiaotong University Affiliated Sixth People's Hospital Shanghai,China

More Information

• Responsible Party: Daqiang Zhao, Shanghai Jiao Tong University Affiliated Sixth People's Hospital
• ClinicalTrials.gov Identifier: NCT02355093
• Other Study ID Numbers: ACB vs FNB
• First Posted: February 4, 2015
• Last Update Posted: February 4, 2015
• Last Verified: January 2015

Additional relevant MeSH terms:

Ropivacaine; Anesthetics, Local; Anesthetics; Central Nervous System Depressants; Physiological Effects of Drugs; Sensory System Agents; Peripheral Nervous System Agents