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Led by University of California, San Diego · Updated on 2025-06-17
40
Participants Needed
1
Research Sites
N/A
Total Duration
Researchers are evaluating whether a continuous adductor canal nerve block provides better pain relief and reduces opioid use compared to a single injection nerve block after total knee replacement surgery. This pilot study involves adults undergoing primary, unilateral total knee arthroplasty and aims to compare pain levels, opioid consumption, and physical therapy progress during the first week after surgery. Participants will be randomly assigned to one of two groups one receiving a single injection of ropivacaine 0.5% followed by a 5-day continuous infusion of ropivacaine 0.2% via an OnQ pump device, and the other receiving only the single injection with no continuous infusion. The nerve block is performed before surgery using ultrasound guidance to target the adductor canal near the saphenous nerve. During the study, participants will be monitored for pain intensity using a numeric rating scale, opioid use, and physical and emotional functioning up to 30 days after surgery. Physical therapy milestones will also be tracked to assess recovery. The study includes safety checks for allergies, informed consent capacity, and contact availability, with total participation lasting up to one month postoperatively.
CONDITIONS
Continuous Versus Single Injection Adductor Canal Blocks for Outpatient Total Knee Arthroplasty
R
Rodney A Gabriel, MD
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University of California, San Diego
Lead Sponsor
This table compares participation in this trial with other options available for this condition. The information is drawn from published research and the trial’s study details and is provided for educational purposes only.
| Factors | Continuous Adductor Canal Block (OnQ pump) | Single Injection Adductor Canal Block |
|---|---|---|
| What it is | A continuous nerve block technique using an OnQ infusion pump to deliver ropivacaine directly to the adductor canal over several days following knee replacement surgery. | A single-injection nerve block procedure delivering ropivacaine into the adductor canal before surgery, typically performed with ultrasound guidance. |
| Role in trial | Studied as the experimental arm to assess its effect on pain control and opioid use after outpatient knee arthroplasty. | Functions as the active control group reflecting common standard practice for adductor canal nerve block in knee arthroplasty. |
| Primary use | Aims to provide continuous regional anesthesia for pain relief after surgery, potentially reducing the need for opioid medications. | Provides single-dose regional anesthesia to relieve pain in the immediate period after surgery. |
| How it is given or performed | A catheter is placed in the adductor canal during the procedure and connected to an OnQ pump that delivers ropivacaine 0.2% over several days. | A standard nerve block needle is used to deliver a one-time injection of ropivacaine 0.5% near the saphenous nerve before surgery under ultrasound guidance. |
| Evidence status | Ongoing clinical investigation; results for this randomized comparison have not yet been posted in the trial registry. Both continuous and single-injection techniques are supported by existing guidelines as regional anesthesia options. | Supported by clinical guidelines and extensive published evidence for reducing pain after knee arthroplasty. Effectiveness and safety are well established in practice. |
| Important limitations | The continuous infusion approach requires proper catheter placement, ongoing management, and careful monitoring for pump/device complications. Specific risks, rare technical failures, or adverse effects are not yet reported for this study. Comparative benefits over single injection techniques are not yet established in this setting. | Pain relief from a single injection block is of limited duration, sometimes requiring additional oral analgesics or rescue medications. May not provide as much sustained analgesia as expected with continuous infusion in some patients. |
Disclaimer: This comparison is created with the help of artificial intelligence(AI) and may contain errors or missing information. It is not medical advice and does not mean one option is better or safer than another. Clinical trials are still being studied, and joining a trial is your choice. Please consult your healthcare professional before making any decisions.
You may qualify if you...
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Duration - 2 to 4 weeks
Participants are screened for eligibility to participate in the trial.
1 visit (in-person)
Duration - 5 days
Participants receive a single injection adductor canal nerve block prior to surgery. Those in the experimental group also receive a 5-day continuous perineural infusion using an OnQ pump for postoperative pain management.
1 baseline visit prior to surgery and daily visits for up to 5 days
Duration - 30 days
Participants are monitored for pain scores, opioid consumption, and physical therapy milestones for up to 30 days after surgery.
Follow-up visits or contacts during the 30-day postoperative period
Study Type
INTERVENTIONAL
Masking
NONE
Allocation
RANDOMIZED
Model
PARALLEL
Primary Purpose
TREATMENT
Number of Arms
2
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Roger Chou, Debra B Gordon, Oscar A de Leon-Casasola...
https://pubmed.ncbi.nlm.nih.gov/26827847/University of California, San Diego
Lead Sponsor
