Different doses of liposomal bupivacaine for adductor canal block after total knee replacement

Is this trial a fit for you?

A plain-English reading of the study's rules. Only the study team can confirm whether you qualify.

What this trial studies

Adults undergoing elective primary unilateral robotic total knee arthroplasty at a single center will receive one of three adductor canal block formulations: standard 0.5% bupivacaine, 1.33% liposomal bupivacaine combined with 0.5% standard bupivacaine, or 1.33% liposomal bupivacaine alone. Pain scores, opioid consumption, and other postoperative outcomes will be recorded in the acute recovery period to compare analgesic duration and effectiveness across doses. The protocol targets ASA I–III patients aged 18–80 and excludes revision, bilateral, or complex procedures and patients with chronic opioid use or certain medical comorbidities. The intervention uses the recently FDA-approved liposomal bupivacaine formulation applied via the adductor canal block to explore optimal dosing for postoperative analgesia.

Why it matters

Who can join: the full rules

Inclusion Criteria:

* ASA I-III
* Age 18-80 years old
* Scheduled for elective primary unilateral total knee arthroplasty (TKA) with robotic surgery
* Able to speak and understand Cantonese or Mandarin or English
* Able to provide informed oral and written consent

Exclusion Criteria:

* Revision TKA
* Single-stage bilateral TKA
* Complex primary TKA requiring use of stem/augment/constrained liner
* Surgeries with significant intraoperative complications which may alter rehabilitation protocol eg collateral ligament injury, fracture requiring fixation
* Known allergy to opioids, local anaesthetic drugs, paracetamol, non-steroidal anti-inflammatory drugs (NSAIDS) including COX-2 inhibitors
* History of chronic pain other than chronic knee pain
* History of immunosuppression
* Chronic use of glucocorticoids
* Chronic opioid use (morphine, fentanyl, hydromorphone, ketobemidone, methadone, nicomorphine, oxycodone, or meperidine)
* History of congestive heart failure (NYHA 2)
* Alcohol or drug abuse
* Impaired renal function (defined as effective glomerular filtration rate \< 30ml/min/1.73m2
* Impaired liver function (defined as plasma bilirubin over 34mol/L; international normalized ratio \[INR\] \>= 1.7, alanine aminotransferase \[ALT\] over 100U/L, aspartate aminotransferase \[AST\] over 100U/L)
* Coagulopathy (platelet count \<100,000/ml and/or INR \>= 1.5) or the use of anticoagulants (not including aspirin) that precludes the use of adductor canal blocks
* Pre-existing neurological or muscular disorders
* Psychiatric illness
* Impaired mental state
* Pregnancy
* Local infection
* On immunosuppressants
* High body mass index (BMI) (\>=40)
* Patient refusal for regional nerve blocks or to conduct clinical trial

Where it's running

• The University of Hong Kong
  Hong Kong, Hong Kong, Hong Kong Recruiting

Study contacts

• Study coordinator: Stanley S.C. WONG, MD (HKU)
• Email: wongstan@hku.hk
• Phone: (852) 2255 3303

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How to take part

1. Review the eligibility criteria above with your treating physician.
2. Check the official listing on ClinicalTrials.gov for the latest contact details and recruitment status.
3. Contact the study coordinator or principal investigator to ask for pre-screening. Pre-screening is free and never obligates you to enroll.