Adding sensory nerve blocks to local pain injections for total knee replacement
Postoperative Analgesia in Patients Undergoing Knee Replacement Surgery - a Study Comparing Intraoperative Local Infiltration Analgesia Only With Ultrasound-guided Nerve Blocks Added to Intraoperative Local Infiltration Analgesia, a Randomized Clinical Trial
This trial tests whether adding three sensory nerve blocks to standard local pain injections reduces pain and opioid use after primary unilateral total knee replacement.
Quick facts
| Phase | Phase 4 |
|---|---|
| Study type | Interventional |
| Enrollment | 200 (estimated) |
| Ages | 18 Years and up |
| Sex | All |
| Sponsor | Region Skane Academic / other |
| Locations | 1 site (Trelleborg) |
| Trial ID | NCT07350252 on ClinicalTrials.gov |
What this trial studies
This is a randomized Phase 4 trial comparing standard local infiltration analgesia (LIA) alone versus LIA plus three sensory nerve blocks (saphenous nerve, nerve to vastus medialis, and anterior femoral cutaneous nerve) in patients having primary unilateral total knee arthroplasty. Pain intensity is the primary outcome and will be measured with the Numerical Rating Scale (NRS) at multiple time points after surgery. Secondary outcomes include opioid consumption, time to mobilization, postoperative nausea and vomiting, length of stay, and neurological complications, with subgroup comparisons between general and spinal anesthesia. The blocks use ropivacaine with clonidine and the trial is conducted at the Department of Anaesthesiology, Trelleborg Hospital, Sweden.
Who should consider this trial
Good fit: Adults scheduled for primary unilateral total knee arthroplasty who can understand spoken and written Swedish and have no contraindications to regional anesthesia or allergy to local anesthetics are ideal candidates.
Not a fit: People who are pregnant, have coagulopathy or other bleeding disorders, allergies to local anesthetics, or cannot understand Swedish are excluded and therefore would not participate or benefit from this protocol.
Why it matters
Potential benefit: If successful, patients could experience better postoperative pain control, need fewer opioids, and mobilize earlier without losing quadriceps strength.
How similar studies have performed: Previous studies have shown adductor canal (sensory) blocks plus LIA can match femoral nerve block for pain while preserving motor function, but combining saphenous, vastus medialis, and anterior femoral cutaneous nerve blocks together with LIA is less well studied.
Eligibility criteria
Show full inclusion / exclusion criteria
Inclusion Criteria: -Undergoing primary unilateral total knee arthroplasty Exclusion Criteria: * Pregnancy * Coagulopathy or other bleeding disorder that precludes regional anesthesia * Allergy to local anesthetics * Inability to understand spoken and written Swedish * Unwillingness to participate in the study
Where this trial is running
Trelleborg
- Department of Anaesthesiology, Trelleborg Hospital — Trelleborg, Sweden (Recruiting)
Study contacts
- Principal investigator: Andreas Ekman, MD, PhD — VO Planned Operations, Trelleborg Hospital, and Lund University, Sweden
- Study coordinator: Fredrik Fellert, MD
- Email: fredrik.fellert@med.lu.se
- Phone: +46736552249
How to participate
- Review the eligibility criteria above with your treating physician.
- Visit the official trial page on ClinicalTrials.gov for the most current contact information and recruitment status.
- Contact the listed study coordinator or principal investigator to request pre-screening. Pre-screening is free and never obligates you to enroll.