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Adductor canal catheters are being used to provide continuous postoperative analgesia after total knee arthroplasty surgery (TKA). There is much debate about where is the best position of continuous adductor canal block in patients undergoing TKA. Therefore, the investigators aim to compare the postoperative pain at three different level of continuous adductor canal block. Ninety six patients scheduled for total knee arthroplasty will be randomly divided into the three groups. In group 1, the adductor canal catheter is inserted at femoral triangle apex (the proximal end of the adductor canal). In group 2, the adductor canal catheter is inserted femur length/15*2 cm above the location where the nerve block performed in group 1. In group 3, the adductor canal catheter is inserted femur length/15cm below the location where the nerve block performed in group 1.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Group 1(femoral triangle apex) | Active Comparator | the adductor canal catheter is inserted at femoral triangle apex (the proximal end of the adductor canal) |
|
| Group 2(femur length/15*2 cm above) | Active Comparator | the adductor canal catheter is inserted femur length/15*2 cm above the location where the nerve block performed in group 1 |
|
| Group 3(femur length/15 cm below) | Active Comparator | the adductor canal catheter is inserted femur length/15cm below the location where the nerve block performed in group 1. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| the three different sites of continous adductor canal block: the adductor canal catheter is inserted at femoral triangle apex | Procedure | In group 1, the adductor canal catheter is inserted at femoral triangle apex (the proximal end of the adductor canal). |
| Measure | Description | Time Frame |
|---|---|---|
| Pain : Visual Analogue Scale (VAS) for pain | The visual analog scale(VAS) is a validated, subjective measure for acute and chronic pain. Scores are recorded by making a handwritten mark on a 10-cm line that represents a continuum between "no pain" (0) and "worst pain." (10). The ends are defined as the extreme limits of the parameter to be measured(symptom,pain,health) orientated from the left(0, worst) to the right(10, best). | Baseline (Before surgery) |
| Pain : Visual Analogue Scale (VAS) for pain | The visual analog scale(VAS) is a validated, subjective measure for acute and chronic pain. Scores are recorded by making a handwritten mark on a 10-cm line that represents a continuum between "no pain" (0) and "worst pain." (10). The ends are defined as the extreme limits of the parameter to be measured(symptom,pain,health) orientated from the left(0, worst) to the right(10, best). | postoperative day 1 |
| Pain : Visual Analogue Scale (VAS) for pain | The visual analog scale(VAS) is a validated, subjective measure for acute and chronic pain. Scores are recorded by making a handwritten mark on a 10-cm line that represents a continuum between "no pain" (0) and "worst pain." (10). The ends are defined as the extreme limits of the parameter to be measured(symptom,pain,health) orientated from the left(0, worst) to the right(10, best). | postoperative day 2 |
| Measure | Description | Time Frame |
|---|---|---|
| muscle strength | Quadriceps strength of both legs was assessed by placing the dynamometer on the anterior of the ankle, between the malleoli. | Baseline (Before surgery) |
| muscle strength | Quadriceps strength of both legs was assessed by placing the dynamometer on the anterior of the ankle, between the malleoli. |
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Inclusion Criteria:
Exclusion Criteria:
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Department of Anesthesiology and Pain Medicine, Anesthesia and Pain Research Institue, Yonsei Universiy College of Medicine | Seoul | 03722 | South Korea |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 31056239 | Background | Chuan A, Lansdown A, Brick KL, Bourgeois AJG, Pencheva LB, Hue B, Goddard S, Lennon MJ, Walters A, Auyong D; Continuous Catheters in Adductor Canal versus Femoral Triangle (The CAFE study) investigators. Adductor canal versus femoral triangle anatomical locations for continuous catheter analgesia after total knee arthroplasty: a multicentre randomised controlled study. Br J Anaesth. 2019 Sep;123(3):360-367. doi: 10.1016/j.bja.2019.03.021. Epub 2019 May 2. | |
| 29750695 |
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Ninety six patients scheduled for total knee arthroplasty will be randomly divided into the three groups. In group 1, the adductor canal catheter is inserted at femoral triangle apex (the proximal end of the adductor canal). In group 2, the adductor canal catheter is inserted femur length/15*2 cm above the location where the nerve block performed in group 1. In group 3, the adductor canal catheter is inserted femur length/15*2 cm below the location where the nerve block performed in group 1.
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Investigator and outcomes assessor are blinded to group assignment.
| the three different sites of continous adductor canal block: the adductor canal catheter is inserted femur length/15*2 cm above the location | Procedure | In group 2, the adductor canal catheter is inserted femur length/15*2 cm above the location where the nerve block performed in group 1. |
|
| the three different sites of continous adductor canal block: the adductor canal catheter is inserted femur length/15 cm below the location | Procedure | In group 3, the adductor canal catheter is inserted femur length/15 cm below the location where the nerve block performed in group 1. |
|
| postoperative day 1 |
| muscle strength | Quadriceps strength of both legs was assessed by placing the dynamometer on the anterior of the ankle, between the malleoli. | postoperative day 2 |
| Background |
| Sztain JF, Khatibi B, Monahan AM, Said ET, Abramson WB, Gabriel RA, Finneran JJ 4th, Bellars RH, Nguyen PL, Ball ST, Gonzales FB, Ahmed SS, Donohue MC, Padwal JA, Ilfeld BM. Proximal Versus Distal Continuous Adductor Canal Blocks: Does Varying Perineural Catheter Location Influence Analgesia? A Randomized, Subject-Masked, Controlled Clinical Trial. Anesth Analg. 2018 Jul;127(1):240-246. doi: 10.1213/ANE.0000000000003422. |
| 35173020 | Derived | Lee B, Park SJ, Park KK, Kim HJ, Lee YS, Choi YS. Optimal location for continuous catheter analgesia among the femoral triangle, proximal, or distal adductor canal after total knee arthroplasty: a randomized double-blind controlled trial. Reg Anesth Pain Med. 2022 Jun;47(6):353-358. doi: 10.1136/rapm-2021-103284. Epub 2022 Feb 16. |
| ID | Term |
|---|---|
| D010003 | Osteoarthritis |
| ID | Term |
|---|---|
| D001168 | Arthritis |
| D007592 | Joint Diseases |
| D009140 | Musculoskeletal Diseases |
| D012216 | Rheumatic Diseases |
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