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A comparison of two anesthetic techniques for total knee replacements: (1) Peri-Articular Injection (PAI), local infiltration between the popliteal artery and capsule of the knee block (IPACK) and single-shot adductor canal block (ACB) vs. (2) PAI, IPACK and continuous adductor canal block catheter (ACC).
Patients will be randomized to one of two groups: one group will receive a PAI, IPACK and single-shot adductor canal block; one group will receive PAI, IPACK and continuous adductor canal block catheter.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Continuous Adductor Canal Catheter (ACC) | Active Comparator | Patients will receive a combined spinal epidural, PAI, IPACK, and a continuous adductor canal catheter |
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| Adductor Canal block with sham catheter | Sham Comparator | Patients will receive a combined spinal epidural, PAI, IPACK, and an adductor canal block. The patient will also receive a sham catheter. |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Continuous Adductor Canal Catheter (ACC) | Device | At the end of the case or in the PACU, a pseudo sham catheter will be affixed mid-thigh to the skin using dermabond, steri-strips, and a chg tegaderm dressing. The catheter will be connected to the disposable pump filled with sterile saline (400 cc) and the flow rate will be set to 0. The pump will be enclosed in a carrier bag provided by the company. To ensure blinding, the carrier bag will be taped to prevent the patient from accessing it. |
| Measure | Description | Time Frame |
|---|---|---|
| Opioid consumption during 24-48 hour period | Patients will be asked to report their opioid consumption during the 24-48 hour time period after spinal induction. This data will be converted to morphine milligram equivalents (mme). | Post-operative day 1-2 (24-48 hours post spinal induction) |
| Measure | Description | Time Frame |
|---|---|---|
| Opioid consumption during post-anesthesia care unit (PACU) stay | Patients will be asked to report their opioid consumption during their stay in the post-anesthesia care unit. This data will be converted to morphine milligram equivalents (mme). | Day of surgery from PACU arrival until transfer to in-patient floor (up to 48 hours) |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| George Birch, BS | Contact | 212-774-7377 | birchg@hss.edu |
| Name | Affiliation | Role |
|---|---|---|
| David Kim, MD | Hospital for Special Surgery, New York | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Hospital for Special Surgery | Recruiting | New York | New York | 10023 | United States |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 42242837 | Derived | Kim DH, Beathe J, Wetmore DS, Goytizolo E, Haskins SC, Swamidoss C, Reichel JF, Reisenger L, Rao P, Memtsoudis SG, Liu J. Single-injection adductor canal block with perineural dexamethasone versus continuous adductor canal catheter for total knee arthroplasty: a randomized controlled trial. Reg Anesth Pain Med. 2026 Jun 4:rapm-2026-107719. doi: 10.1136/rapm-2026-107719. Online ahead of print. |
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| Adductor Canal block with sham catheter | Device | Adductor canal block (ACB) will be administered. At the end of the case or in the PACU, a catheter will be inserted and affixed mid-thigh to the skin using dermabond, steri-strips, and a chg tegaderm dressing. The catheter will be connected to the disposable pump filled with sterile saline (400 cc) and the flow rate will be set to 0. The pump will be enclosed in a carrier bag provided by the company. To ensure blinding, the carrier bag will be taped to prevent the patient from accessing it. |
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