Overview
A comparison of two anesthetic techniques for total knee replacements: (1) Peri-Articular Injection (PAI), local infiltration between the popliteal artery and capsule of the knee block (IPACK) and single-shot adductor canal block (ACB) vs. (2) PAI, IPACK and continuous adductor canal block catheter (ACC).
Description
Patients will be randomized to one of two groups: one group will receive a PAI, IPACK and single-shot adductor canal block; one group will receive PAI, IPACK and continuous adductor canal block catheter.
Eligibility
Inclusion Criteria:
- Patients with osteoarthritis scheduled for a primary total knee arthroplasty with a participating surgeon
- Planned use of regional anesthesia
- Ability to follow study protocol
- English speaking (secondary outcomes include questionnaires validated in English only)
- Lives within one hour of the hospital
- Has a smart phone
Exclusion Criteria:
- Hepatic or renal insufficiency
- Younger than 18 years old or older than 65 years ol
- Patients undergoing general anesthesia
- Allergy or intolerance to one of the study medications
- BMI >40
- Diabetes
- American Society of Anesthesiologists (ASA) status III or IV
- Chronic gabapentin/pregabalin use (regular use for longer than 3 months)
- Patients with chronic pain (from a referral to chronic pain service) or a pain catastrophizing scale (PCS >30)
- Patients with severe valgus deformity or flexion contracture
- Patients unable to follow home catheter instructions and unwilling to go home with an infusing catheter
- Patients who have no home caregivers in the event that a catheter is to be sent home with the patient
- Patients with planned stay at rehab facility (to avoid medical device being tampered with at the rehab facility)
- Non-English speakers (secondary outcomes include questionnaires validated in English only)