Administering adductor canal blocks during knee surgery

A Randomized Controlled Trial Assessing the Efficacy of Surgeon-performed, Intraoperative Adductor Canal Blocks in Same-Day Discharge Total Knee Arthroplasty

This study is testing if a new way for surgeons to give pain relief during knee surgery can help patients feel better and go home sooner compared to the traditional method used by anesthesiologists.

Quick facts

• Phase: NA
• Study type: Interventional
• Enrollment: 80 (estimated)
• Ages: 18 Years and up
• Sex: All
• Sponsor: Ottawa Hospital Research Institute (other)
• Locations: 1 site (Ottawa, Ontario)
• Trial ID: NCT05601427 on ClinicalTrials.gov

What this trial studies

This clinical trial investigates the effectiveness of surgeon-administered adductor canal blocks (sACB) during total knee arthroplasty (TKA) compared to traditional anesthesiologist-performed blocks (aACB). The goal is to improve post-operative pain management, facilitate early ambulation, and reduce hospital stay for patients undergoing TKA. By evaluating the clinical efficacy of sACB, the study aims to determine if this approach can be safely implemented in a same-day discharge setting. Participants will be randomly assigned to receive either sACB or aACB to assess outcomes.

Who should consider this trial

Good fit: Ideal candidates are adults aged 18 and older scheduled for primary total knee arthroplasty due to osteoarthritis.

Not a fit: Patients with contraindications to regional anesthesia or those with non-osteoarthritis diagnoses will not benefit from this study.

Why it matters

Potential benefit: If successful, this approach could enhance pain control and recovery for patients undergoing knee surgery, leading to shorter hospital stays.

How similar studies have performed: While there is limited data on the efficacy of surgeon-administered adductor canal blocks, similar approaches in regional anesthesia have shown promise in other contexts.

Eligibility criteria

Inclusion Criteria:

1. Male and female patients aged 18 years or older
2. Primary TKA booked as SDD
3. Diagnosis of osteoarthritis

Exclusion Criteria:

1. Inability or refusal to sign informed consent form
2. Non-English or French speaking, and no licensed translator, family member or substitute decision maker available.
3. Non-osteoarthritis primary diagnosis
4. Allergy to analgesic medications
5. Contraindication to spinal and/or regional anaesthesia
6. Any use of opioid pain medication within four weeks of the index procedure(13)
7. Pain catastrophizing scale score ≥16 (8, 9, 14)
8. History of cirrhosis
9. History renal insufficiency
10. History or sensory and/or motor neuropathy to the ipsilateral limb
11. Simultaneous, bilateral TKA
12. Non-TKA prosthesis
13. Scheduled for non-SDD TKA.
14. Preoperative varus/valgus of \>10 degrees.
15. Planned General Anaesthetic
16. Use of Intrathecal Morphine

Where this trial is running

Ottawa, Ontario

• The Ottawa Hospital — Ottawa, Ontario, Canada (RECRUITING)

Study contacts

• Principal investigator: Simon Garceau, MD — The Ottawa Hospital
• Study coordinator: Sanjula Costa

Conditions: Knee Osteoarthritis, Knee Arthritis, Knee Pain Chronic, Anesthesia