Effectiveness of Different Doses of Liposomal Bupivacaine in Nerve Block for Pain Relief After Robotic Total Knee Replacement Surgery
Led by The University of Hong Kong · Updated on 2025-11-24
177
Participants Needed
1
Research Sites
52 weeks
Total Duration
AI-Summary
What this Trial Is About
Total knee arthroplasty TKA is a common surgery for severe osteoarthritis when other treatments do not work. However, many patients experience significant pain after surgery, which can slow recovery and increase opioid use. Researchers are studying different doses of liposomal bupivacaine in the adductor canal block, a pain relief technique, to see how it affects pain and opioid use after robotic-assisted TKA. This is a randomized controlled trial sponsored by The University of Hong Kong.
Participants will receive one of three treatments during surgery an adductor canal block with standard bupivacaine, a combination of liposomal and standard bupivacaine, or liposomal bupivacaine alone in different doses. The study will compare the effects of these doses on pain relief and opioid consumption. The trial uses a triple-blind method and includes detailed monitoring of drug levels, pain scores, and recovery measures.
During the study, participants will have their pain levels measured frequently for up to 7 days after surgery, along with assessments of knee function, opioid side effects, and quality of recovery. Blood samples will be taken to check bupivacaine levels. Long-term outcomes such as chronic pain, knee function, and quality of life will be evaluated at 6 weeks, 3 months, and 6 months post-surgery. The primary outcome is the overall pain score at rest during the first 48 hours after surgery.
CONDITIONS
Brief Title
Analgesic Efficacy of Different Liposomal Bupivacaine Doses in the Adductor Canal Block for Total Knee Arthroplasty
Research Team
S
Stanley S.C. WONG, MD (HKU)
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Scheduled for elective primary unilateral total knee arthroplasty with robotic surgery
Able to speak and understand Cantonese, Mandarin, or English
Able to provide informed oral and written consent
You will not qualify if you...
Revision total knee arthroplasty
Single-stage bilateral total knee arthroplasty
Complex primary total knee arthroplasty requiring stem, augment, or constrained liner
Surgeries with major complications affecting rehabilitation such as ligament injury or fracture requiring fixation
Known allergy to opioids, local anesthetic drugs, paracetamol, or NSAIDs including COX-2 inhibitors
History of chronic pain other than chronic knee pain
History of immunosuppression or current use of immunosuppressants
Chronic use of glucocorticoids
Chronic opioid use
History of congestive heart failure (NYHA class 2)
Alcohol or drug abuse
Impaired renal function (eGFR less than 30 ml/min/1.73m2)
Impaired liver function (high bilirubin, INR ≥ 1.7, ALT or AST over 100 U/L)
Blood clotting disorders or use of anticoagulants that prevent adductor canal block
Pre-existing neurological or muscular disorders
Psychiatric illness or impaired mental state
Pregnancy
Local infection
Body mass index 40 or higher
Refusal of regional nerve blocks or clinical trial participation
Your Study Journey
Screening
Duration - 2 to 4 weeks
Participants are screened for eligibility to participate in the trial.
1 visit (in-person)
Treatment
Duration - Up to 7 days after surgery
Participants receive an adductor canal block with one of three doses of bupivacaine to manage pain after total knee arthroplasty.
1 baseline visit and daily visits up to postoperative day 7
Follow-up
Duration - Up to 6 months after surgery
Participants are monitored for recovery, side effects, and pain outcomes after treatment.
Visits at 6 weeks, 3 months, and 6 months post-surgery
How is the study designed?
Study Type
INTERVENTIONAL
Masking
TRIPLE
Allocation
RANDOMIZED
Model
PARALLEL
Primary Purpose
TREATMENT
Number of Arms
3
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Published Research Related To This Trial
A prospective, randomized trial of liposomal bupivacaine compared to conventional bupivacaine on pain control and postoperative opioid use in adults receiving adductor canal blocks for total knee arthroplasty.
Aurora Quaye, Brian McAllister, Joseph R Garcia...
Adductor canal block combined with local infiltration analgesia versus isolated adductor canal block in reducing pain and opioid consumption after total knee arthroplasty: a systematic review and meta-analysis.
Dose adductor canal block combined with local infiltration analgesia has a synergistic effect than adductor canal block alone in total knee arthroplasty: a meta-analysis and systematic review.