Anesthesia Clinical Trial
Official title:
Do Peripheral Nerve Blocks When Used as Part of a Multimodal Regimen Inclusive on Intrathecal Morphine Improve Analgesia After Unilateral Total Knee Arthroplasty? A Randomized Controlled Trial
The purpose of this study is to determine whether intrathecal morphine (ITM) alone or its combination with peripheral nerve blocks (PNB) provides better analgesia for patients undergoing total knee arthroplasty (TKA).
Total knee arthroplasty (TKA) surgery is associated with severe pain. The success of knee
rehabilitation following surgery depends largely on adequate pain control that permits early
physical therapy. Postoperative modern analgesic recommendations specific to TKA propose
either spinal block with intrathecal morphine (ITM) or a combination of general anesthesia
with single shot femoral nerve block (SFNB). Femoral nerve block (FNB) too has proven
analgesic advantages in TKA surgery. However, we do not know if the combination of the two
analgesic techniques, ITM and peripheral nerve blocks (PNB), provides superior analgesia to
ITM alone.
Thus, this study aims to determine whether ITM alone or its combination with PNB provides
better analgesia for patients undergoing total knee arthroplasty (TKA).
Eligible patients undergoing unilateral TKA under spinal anesthesia consenting to a
multimodal analgesic regimen inclusive of ITM, FNB, and SNB will be recruited. All patients
will receive spinal with intrathecal morphine. Patients will be randomly assigned using a
computer generated table of random numbers to receive either spinal with intrathecal morphine
(morphine group), a combination of intrathecal morphine and femoral nerve block
(morphine-femoral group), or a combination of intrathecal morphine and femoral nerve block as
well as sciatic nerve block (morphine-femoral-sciatic group).
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