Nerve Block Clinical Trial
Official title:
Catheter Over Needle Technique Causes Less Leakage and Secondary Failure Than Catheter Through Needle Technique for Continuous Femoral Nerve Block
To randomize 108 patients undergoing knee replacement surgery to catheter through needle or catheter over needle femoral nerve blocks, then monitor the catheters for leakage to see if there is a difference.
Background: Total Knee Replacement Surgery is a commonly performed procedure that causes
significant post-operative pain. Continuous femoral nerve blocks are widely used for
analgesia as part of a multimodal analgesic regimen for this surgery. They provide sustained
analgesia which allows early physiotherapy for rehabilitation. Currently the most common
technique for inserting catheters for continuous femoral nerve blocks is to feed a catheter
though a needle (CTN) which has been placed close by the nerve. There is a significant rate
of leak and dislodgement of these catheters which can lead secondary failure where the
catheter is no longer providing analgesia by blocking the nerve (primary failure occurs when
the nerve block catheter fails to provide any analgesia from the start). The system to be
investigated has a catheter over the needle (CON) which is left in place after the needle is
withdrawn. The proposed benefit of this is that there will be a reduction in leak rates and
dislodgement. This is because using a CON technique means that the biggest hole will be the
diameter of the catheter, rather than CTN where the biggest hole will be the diameter of the
needle therefore allowing leak around the outside of the catheter.
Objectives: To ascertain whether or not the catheter over needle technique is superior to
catheter through needle technique in terms of a leak rate.
Trial plan: To recruit 108 patients who are having total knee replacement surgery into the
study and randomise them into having either CON or CTN continuous femoral nerve blocks.
;
Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Single Blind (Subject), Primary Purpose: Treatment
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