Continuous versus single adductor canal nerve block for outpatient total knee replacement
A Pilot Randomized Controlled Trial Assessing Pain and Opioid Outcomes Among Patients Undergoing Total Knee Arthroplasty Receiving 5-Day Outpatient Adductor Canal Continuous Versus Single Injection Blocks
This test checks whether adding a 5-day continuous adductor canal nerve block to the usual single injection lowers pain and opioid use after outpatient total knee replacement.
Quick facts
| Phase | Phase 4 |
|---|---|
| Study type | Interventional |
| Enrollment | 40 (estimated) |
| Ages | 18 Years and up |
| Sex | All |
| Sponsor | University of California, San Diego Academic / other |
| Locations | 1 site (La Jolla, California) |
| Trial ID | NCT06784882 on ClinicalTrials.gov |
What this trial studies
This single-center, randomized pilot at UC San Diego will enroll adults having primary, unilateral outpatient total knee arthroplasty and randomize them to either a single‑injection adductor canal block alone or the same single injection plus a 5‑day continuous perineural infusion of ropivacaine via an OnQ pump. Pain scores (numeric rating scale), opioid consumption, and physical therapy milestones will be recorded from postoperative day 0 through day 7. Eligibility excludes chronic opioid users above a modest threshold, patients with neuromuscular deficits of the surgical limb, planned admission after surgery, pregnancy, and allergy to amide local anesthetics. The goal is to see if the continuous infusion provides better early analgesia and functional progress than a single injection alone.
Who should consider this trial
Good fit: Adults (≥18 years) undergoing a primary, unilateral outpatient total knee arthroplasty who are planned for a single‑injection adductor canal block, weigh more than 50 kg, and do not have exclusion criteria such as chronic high‑dose opioid use or local anesthetic allergy.
Not a fit: Patients with chronic opioid dependence, neuromuscular deficits in the surgical limb, planned inpatient admission, allergy to amide local anesthetics, or those unable to be contacted during the treatment period are unlikely to benefit from this protocol.
Why it matters
Potential benefit: If successful, adding a continuous adductor canal block could reduce postoperative pain, decrease opioid requirements, and help patients reach physical therapy goals sooner after knee replacement.
How similar studies have performed: Prior studies of continuous peripheral nerve infusions for knee arthroplasty have shown improved short‑term pain control and reduced opioid use in some reports, but results are mixed and outpatient‑specific evidence remains limited.
Eligibility criteria
Show full inclusion / exclusion criteria
Inclusion Criteria: 1. Adult participants of at least 18 years of age 2. Undergoing a primary, unilateral, total knee arthroplasty 3. Planned single-injection adductor canal nerve block 4. Weight \> 50 kg (to minimize the risk of local anesthetic toxicity) Exclusion Criteria: 1. chronic opioid or tramadol use: daily oxycodone equivalents \> 20 mg for \> 4 weeks 2. neuro-muscular deficit of the surgical limb 3. moderate pain (NRS \> 3) in an anatomic location other than the surgical site 4. planned hospital admission following surgery 5. history of opioid misuse 6. those who lack capacity to complete informed consent 7. inability to contact the investigators during the treatment period, and vice versa (e.g., lack of telephone access) 8. incarceration 9. pregnancy 10. allergy to amide local anesthetics
Where this trial is running
La Jolla, California
- University of California, San Diego — La Jolla, California, United States (Recruiting)
Study contacts
- Study coordinator: Rodney A Gabriel, MD
- Email: ragabriel@health.ucsd.edu
- Phone: 858-663-7747
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.