Total Knee Arthroplasty Clinical Trial
Official title:
Low Dose Spinal Bupivacaine for Total Knee Arthroplasty and Recovery Room Wait Time
This study plans to investigate whether a reduced dose of bupivacaine (a local anesthetic numbing drug) injected into the spinal space for a total knee replacement will result in a shorter time to discharge from the recovery room while maintaining adequate surgical anesthesia.
With the doses of bupivacaine currently being used in spinal anesthetics at our institution,
patients' sensory blocks are often much higher than needed to achieve adequate surgical
anesthesia. This translates into a prolonged waiting period in the recovery room before the
level regresses down to the pre-existing standard for discharge to the ward, as well as the
pre-existing level before a post-operative nerve block for extended pain relief can be
performed. This prolonged period in the recovery room leads to general delays in operating
room usage and thus surgical cancellations. The excessive drug doses currently used also put
patients at risk for increasing side effects including low blood pressure, slow heart rates,
and nausea and vomiting.
By using a reduced dose of bupivacaine in a spinal anesthetic for a one sided knee
replacement, we hope to significantly reduce the recovery room waiting times until the
criteria for recovery room discharge or completion of a post-operative nerve block are met,
while still providing adequate surgical anesthesia.
Patients will receive either 9 mg (intervention dose) or 13 mg (control dose) of bupivacaine
through a spinal injection. Once the patients enter the recovery room after surgery the
level of their sensory block will be tested as per usual protocol by the recovery room
nurses every 15 minutes until a predefined level has been reached, and the two groups will
be compared.
;
Allocation: Randomized, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Parallel Assignment, Masking: Double Blind (Subject, Investigator), Primary Purpose: Treatment
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