Adductor Canal Block Versus Patient Controlled Analgesia, in the Surgical Stress Response for Anterior Cruciate Ligament Repair
Study Details
Study Description
Brief Summary
To evaluate the surgical stress response in anterior cruciate ligament repair with an adductor canal block versus patient controlled endovenous analgesia.
Condition or Disease | Intervention/Treatment | Phase |
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|
Phase 1 |
Detailed Description
Preoperative, 2 hours and 24 hours stress biomarkers will be evaluated in two groups of patients, continous adductor canal block and morphine patient controlled endovenous analgesia.
Study Design
Arms and Interventions
Arm | Intervention/Treatment |
---|---|
Experimental: Adductor Canal Block With mild sedation, a continous bupivacaine 0.1% infusion catheter is placed in the adductor canal. Afterwards, patients are placed under General Anesthesia, and surgery starts. Preoperative, 2 hours and 24 hours stress biomarkers and analgesic quality will be measured. |
Procedure: Adductor Canal Block
Continous peripheral nerve block
|
Active Comparator: Patient Controlled Morphine Analgesia Patients are placed under General Anesthesia, and after surgery, a Morphine patient controlled analgesia delivery system is installed. Preoperative, 2 hours and 24 hours stress biomarkers and analgesic quality will be measured. |
Device: Morphine Patient Controlled Analgesia
Morphine Patient Controlled Analgesia Delivery System
Other Names:
|
Outcome Measures
Primary Outcome Measures
- Change of Blood Cortisol from baseline to 24 hours [24 hours]
Blood Cortisol will be evaluated preoperatively, 2 hours and 24 hours postoperatively.
Secondary Outcome Measures
- Change of C Reactive Protein from baseline to 24 hours [24 hours]
C Reactive Protein will be evaluated preoperatively, 2 hours and 24 hours postoperatively.
- Change of Glycemia from baseline to 24 hours [24 hours]
Glycemia will be evaluated preoperatively, 2 hours and 24 hours postoperatively.
Eligibility Criteria
Criteria
Inclusion Criteria:
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Male,
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18-65 years,
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traumatic Anterior Cruciate Ligament tear, scheduled for elective arthroscopic repair with Semitendinous-Gracillis technique at first time in the morning, with full articular range,
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no other traumatologic lesions.
Exclusion Criteria:
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denied consent to participate,
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chronic steroids user,
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diabetes type 1 or 2,
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insulin resistance,
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concurrent infectious disease,
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cognitive failure, coagulopathy,
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allergy to study drugs,
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surgery scheduled in the afternoon
Contacts and Locations
Locations
Site | City | State | Country | Postal Code | |
---|---|---|---|---|---|
1 | Pontificia Universidad Católica de Chile | Santiago | Chile |
Sponsors and Collaborators
- Pontificia Universidad Catolica de Chile
Investigators
- Principal Investigator: Fernando Altermatt, MD, PUC
Study Documents (Full-Text)
None provided.More Information
Publications
- Ahlers O, Nachtigall I, Lenze J, Goldmann A, Schulte E, Höhne C, Fritz G, Keh D. Intraoperative thoracic epidural anaesthesia attenuates stress-induced immunosuppression in patients undergoing major abdominal surgery. Br J Anaesth. 2008 Dec;101(6):781-7. doi: 10.1093/bja/aen287. Epub 2008 Oct 15.
- Bagry H, de la Cuadra Fontaine JC, Asenjo JF, Bracco D, Carli F. Effect of a continuous peripheral nerve block on the inflammatory response in knee arthroplasty. Reg Anesth Pain Med. 2008 Jan-Feb;33(1):17-23.
- Cuellar VG, Cuellar JM, Golish SR, Yeomans DC, Scuderi GJ. Cytokine profiling in acute anterior cruciate ligament injury. Arthroscopy. 2010 Oct;26(10):1296-301. doi: 10.1016/j.arthro.2010.02.011.
- Desborough JP. The stress response to trauma and surgery. Br J Anaesth. 2000 Jul;85(1):109-17. Review.
- Fant F, Tina E, Sandblom D, Andersson SO, Magnuson A, Hultgren-Hörnkvist E, Axelsson K, Gupta A. Thoracic epidural analgesia inhibits the neuro-hormonal but not the acute inflammatory stress response after radical retropubic prostatectomy. Br J Anaesth. 2013 May;110(5):747-57. doi: 10.1093/bja/aes491. Epub 2013 Jan 7.
- Fowler SJ, Symons J, Sabato S, Myles PS. Epidural analgesia compared with peripheral nerve blockade after major knee surgery: a systematic review and meta-analysis of randomized trials. Br J Anaesth. 2008 Feb;100(2):154-64. doi: 10.1093/bja/aem373. Review.
- Hong JY, Yang SC, Yi J, Kil HK. Epidural ropivacaine and sufentanil and the perioperative stress response after a radical retropubic prostatectomy. Acta Anaesthesiol Scand. 2011 Mar;55(3):282-9. doi: 10.1111/j.1399-6576.2010.02360.x. Epub 2010 Nov 25.
- Martin F, Martinez V, Mazoit JX, Bouhassira D, Cherif K, Gentili ME, Piriou P, Chauvin M, Fletcher D. Antiinflammatory effect of peripheral nerve blocks after knee surgery: clinical and biologic evaluation. Anesthesiology. 2008 Sep;109(3):484-90. doi: 10.1097/ALN.0b013e318182c2a1.
- Richardson J, Sabanathan S, Jones J, Shah RD, Cheema S, Mearns AJ. A prospective, randomized comparison of preoperative and continuous balanced epidural or paravertebral bupivacaine on post-thoracotomy pain, pulmonary function and stress responses. Br J Anaesth. 1999 Sep;83(3):387-92.
- Sharma A, Aoun P, Wigham J, Weist S, Veldhuis JD. Gender determines ACTH recovery from hypercortisolemia in healthy older humans. Metabolism. 2013 Dec;62(12):1819-29. doi: 10.1016/j.metabol.2013.08.014. Epub 2013 Sep 25.
- Weissman C. The metabolic response to stress: an overview and update. Anesthesiology. 1990 Aug;73(2):308-27. Review.
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