Actively Recruiting
Post-Operative Urinary Retention on Revision Knee Arthroplasty: the Role of Intrathecal Morphine
Led by University of Toronto · Updated on 2025-12-29
50
Participants Needed
1
Research Sites
109 weeks
Total Duration
On this page
AI-Summary
What this Trial Is About
Revision total knee arthroplasty (rTKA) is a frequently performed procedure. Adequate pain management is an important feature, especially for fast-track and Enhanced Recovery After Surgery (ERAS) programs. The multimodal approach, including single shot or continuous nerve blocks with catheters and spinal or epidural morphine, is a stablished strategy. Although the administration of intrathecal morphine (IM) has been shown to significantly reduce pain scores, it is not free of adverse effects. Postoperative urinary retention (POUR) is possible and might increase the risk of periprosthetic infection. The purpose of this study is to compare patients undergoing rTKAS under spinal anesthesia with IM to patients undergoing the same procedure, under the same anesthetic technique, but with no IM, for POUR and postoperative pain related outcomes. All patients will have single shot and continuous adductor canal block (CACB) and single shot IPACK (interspace between the popliteal artery and the posterior knee capsule) block. The hypothesis is that postoperative pain control is comparable between the groups, with lower incidence of POUR in patients with no IM given.
CONDITIONS
Official Title
Post-Operative Urinary Retention on Revision Knee Arthroplasty: the Role of Intrathecal Morphine
Who Can Participate
Eligibility Criteria
You may qualify if you...
- Non pregnant patients undergoing unilateral non infected revision total knee arthroplasty surgery
- Older than 21 years of age with American Society of Anesthesiologists (ASA) physical status I-III
- No history of alcohol or drug dependency
- Able to understand and cooperate with use of a perineural catheter for pain management
- Body mass index (BMI) under 45
- No allergy to study medications including bupivacaine, lidocaine, ropivacaine, midazolam, propofol, ketamine, morphine, hydromorphone, fentanyl, acetaminophen, celecoxib, ondansetron, dexamethasone, tranexamic acid
- No current or recent use of opioids (within last 2 weeks) with average oral morphine equivalent of 20 mg/day or higher
- No contraindications for neuraxial anesthesia, IPACK block, adductor canal block, and catheter insertion
- Able to speak and understand English
- Agrees to participate by signing informed consent
You will not qualify if you...
- Failed spinal anesthesia requiring conversion to general anesthesia
- Inability to perform peripheral nerve blocks due to technical difficulties
- Deviations from study protocol during patient care
- Issues with continuous adductor canal catheter function, disconnection, or exteriorization within first 48 hours of infusion
- Patient withdrawal from the study
AI-Screening
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Trial Site Locations
Total: 1 location
1
Mount Sinai Hospital
Toronto, Ontario, Canada, M5G 1X5
Actively Recruiting
Research Team
H
Hermann dos Santos Fernandes, MD, PhD
CONTACT
How is the study designed?
Study Type
INTERVENTIONAL
Masking
QUADRUPLE
Allocation
RANDOMIZED
Model
PARALLEL
Primary Purpose
PREVENTION
Number of Arms
2
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