Ignite Creation Date:
2024-05-06 @ 3:39 PM
Last Modification Date:
2024-10-26 @ 1:54 PM
Study NCT ID:
NCT04715152
Status:
COMPLETED
Last Update Posted:
2024-06-14
First Post:
2021-01-15
Brief Title:
ACB Versus IA Analgesia in Knee Arthroscopy
Sponsor:
Assiut University
Organization:
Assiut University
Study Overview
Official Title:
Adductor Canal Block Versus Intra-articular Analgesia for Postoperative Pain After Arthroscopic Anterior Cruciate Ligament Reconstruction a Randomized Trial
Status:
COMPLETED
Status Verified Date:
2024-06
Last Known Status:
Recruiting
Delayed Posting:
No
If Stopped, Why?:
Not Stopped
Has Expanded Access:
False
If Expanded Access, NCT#:
N/A
Has Expanded Access, NCT# Status:
N/A
Acronym:
None
Brief Summary:
Reconstruction of the anterior cruciate ligament ACL of the knee is a painful procedure and effective postoperative analgesia is important for early return of patient activity
Detailed Description:
Reconstruction of the anterior cruciate ligament ACL of the knee is a painful procedure with postoperative analgesia providing patient comfort early mobilization and discharge within 24 hours
Various methods for postoperative analgesia management are available such as systemic opioids epidural local anesthetic peripheral nerve block and local anesthetic infiltration analgesia Use of systemic opioids can cause adverse effects that may affect functional rehabilitation such as nausea vomiting pruritus sedation and respiratory depression Hypotension urinary retention and pruritus are more common in patients with epidural analgesia In addition use of long-acting intrathecal opioids causes adverse effects such as bilateral motor block tremor and hypotension Systemic and intrathecal methods for postoperative analgesia are gradually being abandoned because of these negative effects
The saphenous nerve is the largest contributor to sensory perception around the knee while the adductor canal contains the nerve to the vastus medialis the medial femoral cutaneous nerve the medial retinacular nerve articular branches from the posterior division of the obturator nerve and occasionally the anterior branch of the obturator nerve Although adductor canal block ACB can contribute towards motor blockade of the periarticular musculature its effect on functional weakness of the quadriceps has been reported to be minimal compared with femoral nerve block FNB
Intra-articular IA local anesthetic agents have been used either alone or in combination with other agent However it was observed that use of combination of drug is better than single drug for prevention of postoperative pain providing synergistic effect and reducing side effects compared to high dose of single drug
Dexamethasone is a potent and highly selective glucocorticoid with minimal mineralocorticoid effect It blocks the nociceptive impulse transmission along the myelinated C fibers Dexamethasone prolongs the duration of regional blocks when combined with local anesthetics
Various methods for postoperative analgesia management are available such as systemic opioids epidural local anesthetic peripheral nerve block and local anesthetic infiltration analgesia Use of systemic opioids can cause adverse effects that may affect functional rehabilitation such as nausea vomiting pruritus sedation and respiratory depression Hypotension urinary retention and pruritus are more common in patients with epidural analgesia In addition use of long-acting intrathecal opioids causes adverse effects such as bilateral motor block tremor and hypotension Systemic and intrathecal methods for postoperative analgesia are gradually being abandoned because of these negative effects
The saphenous nerve is the largest contributor to sensory perception around the knee while the adductor canal contains the nerve to the vastus medialis the medial femoral cutaneous nerve the medial retinacular nerve articular branches from the posterior division of the obturator nerve and occasionally the anterior branch of the obturator nerve Although adductor canal block ACB can contribute towards motor blockade of the periarticular musculature its effect on functional weakness of the quadriceps has been reported to be minimal compared with femoral nerve block FNB
Intra-articular IA local anesthetic agents have been used either alone or in combination with other agent However it was observed that use of combination of drug is better than single drug for prevention of postoperative pain providing synergistic effect and reducing side effects compared to high dose of single drug
Dexamethasone is a potent and highly selective glucocorticoid with minimal mineralocorticoid effect It blocks the nociceptive impulse transmission along the myelinated C fibers Dexamethasone prolongs the duration of regional blocks when combined with local anesthetics
Study Oversight
Has Oversight DMC:
None
Is a FDA Regulated Drug?:
False
Is a FDA Regulated Device?:
False
Is an Unapproved Device?:
None
Is a PPSD?:
None
Is a US Export?:
None
Is an FDA AA801 Violation?:
None