Enhanced Recovery After Major Surgery and Chronic Pain for Total Knee Arthroplasty
Expanding the Peri-operative Surgical Home Model: ERAS TKR With a Transitional Pain Service (TeleTPS) - Continuous Adductor Canal Catheter Versus Adductor Canal Block for Total Knee Arthroplasty, a Randomized Double-blinded Controlled Trial.
Hospital for Special Surgery, New York
64 participants
Jun 12, 2023
INTERVENTIONAL
Conditions
Summary
The goal of this interventional clinical trial is to assess opioid consumption 24-48 hrs post anesthesia block among patients undergoing total knee arthroplasty. The main question it aims to answer is: 1\. Is there a difference in opioid consumption 24-48 hours post block administration among patients that receive an adductor canal catheter (ACC) versus adductor canal block (ACB)? Participants will be: * Randomized to receive an adductor canal catheter (ACC) or a sham adductor canal catheter. * Asked to use the Diagnotes application to communicate with the pain doctor while the catheter is in place. * Follow up for up to 6 months post-operation. Researchers will compare the interventional group (ACC) to the control group (sham ACC + ACB) to see if there is difference in opioid consumption and chronic pain at 6 months post-operation.
Eligibility
Inclusion Criteria8
- Patients with osteoarthritis scheduled for a primary total knee arthroplasty with a participating surgeon
- Age 18 to 75 years
- Planned use of regional anesthesia
- Ability to follow study protocol
- English speaking (secondary outcomes include questionnaires validated in English only)
- Patients of participating surgeons: Drs. Mayman, Jerabek, Westrich, Su, Della Valle, Alexiades
- Lives within one hour of the hospital
- Has a smartphone
Exclusion Criteria14
- Hepatic or renal insufficiency
- Younger than 18 years old and older than 65
- Patients undergoing general anesthesia
- Allergy or intolerance to one of the study medications
- BMI > 40
- Diabetes
- ASA of III,IV
- Chronic gabapentin/pregabalin use (regular use for longer than 3 months)
- PCS > 30
- Chronic opioid use (taking opioids for longer than 3 months, or daily oral morphine equivalent of >5mg/day for one month)
- Patients with severe valgus deformity or flexion contracture
- Patients unable to follow home catheter instructions and unwilling to go home with an infusing catheter
- Patients who have no home caregivers in the event if a catheter is to be sent home with the patient
- Patients with planned stay at rehab facility
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Interventions
0.2% ropivacaine will be infused through a catheter pump at a rate of 10 ml/hr, 600 ml reservoir.
sham catheter with no infusion
Locations(1)
View Full Details on ClinicalTrials.gov
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NCT05981105