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The study aims to investigate the effect of the Popliteal plexus block (PPB) on postoperative pain after total knee arthroplasty
Cadaver dissection studies have shown a spread of dye to the popliteal fossa and colored the popliteal plexus by injecting in the distal part of the adductor Canal.
The popliteal plexus is formed by contribution from the tibial and the obturator nerves.
Investigators hypothesized that a PPB may reduce postoperative pain after total knee arthroplasty.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Popliteal plexus block | Experimental | Patients with an FTB, reporting postoperative pain (NRS > 3) will have a popliteal plexus block |
|
| No intervention | No Intervention | Patients with postoperative pain NRS < or = 3 |
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Bupivacaine-epinephrine | Drug | Popliteal plexus block with 10 mL of bupivacaine-epinephrine 5 mg/mL + 5 microgram/mL. |
|
| Measure | Description | Time Frame |
|---|---|---|
| The percentage of patients with postoperative pain NRS | Evaluated as the percentage of patients with postoperative pain NRS >3, dropping in pain score to NRS = or < 3 after the PPB | 0 - 60 minutes |
| Measure | Description | Time Frame |
|---|---|---|
| Percentage of patients having a femoral triangle block(FTB) reporting NRS > 3 | Percentage of patients having a FTB, reporting postoperative pain NRS >3 | Pain scores every 15 minutes (from end injection FTB to NRS>3 or 3 hours after full sensation of the leg) |
| Onset time of PPB |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Charlotte Runge, MD | University of Aarhus | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Silkeborg Regionalhospital | Silkeborg | 8600 | Denmark |
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Pilot Study
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Time from end of injection of PPB to NRS = or < 3 |
| NRS every 5 minutes after PPB (From 0 - 60 minutes after PPB) |
| Turn off time of spinal anesthesia | Time from arrival in PACU to normal cutaneous sensation (measured by a neuro-pen, sensation=point 2) on the lateral part of the thigh and lateral part of the lower leg | Time from arrival in PACU and during maximum 6 hours |
| Correlation between normal cutaneous sensation and developing of pain | Correlation between normal cutaneous sensation (measured by a neuro-pen, sensation=point 2) and developing of pain (NRS>3) | From arrival in PACU and during maximum 6 hours |
| The effect of the PPB on cutaneous sensation | Tested on the lateral part of the lower leg | NRS every 5 minutes after PPB (From 0 - 60 minutes after PPB) |
| The effect of the PPB on muscle strength of the foot | Dorsal flexion and plantar flexion in the ankle joint, measured with a handheld dynamometer | Baseline and 1 hour after PPB |