Pain Clinical Trial
Official title:
Nociceptin Concentration in Synovial Fluid and Plasma in Patients Undergoing Primary Total Knee Arthroplasty: A Prospective Pilot Study
Nociceptin/Orphanin is a novel opioid peptide system associated with inflammatory response. Currently is it uncertain as to the presence of absence of nociceptin in synovial fluid of patients. Nociceptin levels will be measured pre-operatively and post-operatively in plasma levels of patients receiving primary total knee arthroplasty. Nociceptin levels will also be measured in synovial fluid levels prior to surgical manipulation.
This is a prospective observational study where nociceptin levels will be drawn from the
patient's serum as well as from the patient's synovial fluid. The blood draws will be
completed by the anesthesia team and the synovial fluid and tissue will be obtained by the
orthopedic team. The initial blood draw will be in the preoperative area and the second
blood draw will be five minutes after the release of the tourniquet. The synovial fluid will
be drawn by the surgeon with the first incision. There will be no randomization nor control
group.
Endpoints:
1. The level or absence of nociceptin in synovial fluid in patients receiving total knee
primary arthroplasty will be measured via ELISA in picograms per volume.
2. The level or absence of nociceptin in plasma in patients receiving total knee primary
arthroplasty both in the preoperative period (less than 1 hour prior to surgery and 5
minutes after the tourniquet is removed) via ELISA in picograms per volume.
3. Determine the changes if any of nociception plasma levels during the perioperative
course of patients receiving total primary knee arthroplasty.
Secondary Study Endpoints:
1. Determine the effect if present of history of chronic pain and opioid use on the levels
of nociception present in patients' synovial fluid and plasma receiving primary total
knee arthroplasty.
2. Determine the effect if present of demographic factors on the levels of nociception
present in patients' synovial fluid and plasma receiving primary total knee
arthroplasty
;
Observational Model: Case-Only, Time Perspective: Prospective
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