Total Knee ArthroplastyCACBNCT05962970
Continuous Adductor Canal Block in Fast Track Total Knee Arthroplasty
A study testing continuous adductor canal block (CACB) ropivacaine in people with Total Knee Arthroplasty, run by Samuel Lunenfeld Research Institute, Mount Sinai Hospital at 1 site in Canada.
Trial summary
Total knee arthroplasty (TKA) is a frequent performed surgery. Many institutions are implementing fast track programs for this surgery and adequate pain management is an important feature. Analgesic duration of single shot nerve blocks is limited to no more than 24h. Read more about this study
- Who is it for?
- Ages 21 years and olderHealthy volunteers can take part
- Conditions the study is for
- Total Knee Arthroplasty
- What is being tested?
- continuous adductor canal block (CACB) ropivacaine
- Type of treatment
- Injection or infusion
- Could I receive a placebo?
- Yes, some participants may receive a placebo
- How many people
- 60 participants
- Where
- 1 siteCanada
- Study dates
- 4 Oct 2023to 30 Dec 2025
- Phase
- Interventional
- Are there results?
- None posted in the registry
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 21 years and older
- All sexes
- Healthy volunteers accepted
- Adult, Older adult
Who may be able to join
- Patients undergoing unilateral primary TKA in the fast track setting.
- Patients older than 21 years of age, with American Society of Anesthesiologists (ASA)
- Physical status I-III
- No alcohol or drug dependency
- Sufficient understand and co-operation about the perineural catheter.
Who cannot join
- Perioperative complication or discharge delay leading to hospital admission.
- Chronic opioid use of morphine 30mg equivalent per day for last 2 consecutive weeks.
- Allergy to the study medications;
- Coagulopathy and platelet count < 105/μL;
- Patients with contraindications to the insertion of an epidural or adductor canal catheter (severe anatomic abnormalities or history of previous surgery at the site of catheter placement).
Trial locations and contacts
1 site in 1 country.
About this study
Total knee arthroplasty (TKA) is a frequent performed surgery. Many institutions are implementing fast track programs for this surgery and adequate pain management is an important feature. Analgesic duration of single shot nerve blocks is limited to no more than 24h. Conversely, the use of continuous nerve block (CNB) through a perineural catheter and infusion of local anesthetic may increase duration of analgesia and provide better outcomes. The purpose of this study is to evaluate effectiveness and safety of using CNB in patients undergoing ambulatory TKA, and its effects on patients' quality of recovery. Investigators hypothesize that continuous adductor canal block would lead to decrease in opioid consumption in patients undergoing fast track TKA.
Significance There are no published prospective randomized controlled trials to assess patient's reported quality of recovery after receiving CACB in same day primary knee arthroplasties. As this is a frequent type of surgery and has the prediction to increase its incidence for the next years, there is significant importance in investigations about interventions which may improve its recovery in a fast track regime. A postoperative analgesic technique that offers better pain control, has less adverse effects, reduces the opioid analgesia requirement and is safe to be used in a fast track setting may have additional impact on decreasing health care cost and may lead to an enhanced recovery and better quality of life.
Objectives To evaluate effectiveness and safety of using CACB in patients undergoing ambulatory TKA, in comparison to SACB. Primary objective is opioid consumption (in oral morphine equivalent doses) Secondary objectives are to evaluate postoperative QoR-15 scores (10), pain scores, opioid-induced adverse effects (measured via validated opioid symptom distress scale), postoperative functional status, complications relating to the perineural catheter and readmissions.
Read the detailed description
Objectives The aim of this study is to examine the effect of CACB on decreasing opioid consumption, increasing the Quality of Recovery (measured via QoR-15) total score and decreasing opioid-related side effects. Investigators will also assess the rate of readmissions in primary knee arthroplasty patients.
Rationale
Pain management in knee arthroplasty patients poses unique challenges for the anesthesiologist, especially in the immediate post-operative period. Early postoperative analgesia is limited to a unimodality of intravenous opioids. Recently, adductor canal blocks have started to replace femoral blocks, as this technique can provide similar analgesic results while avoiding the quadriceps muscle weakness associated with femoral nerve blocks. The use of a continuous adductor canal catheter in the post-discharge phase shows promising as the next step in knee arthroplasty pain management allowing for shorter lengths of stay or even same day discharge (3).
Significance and Innovation
Total knee arthroplasty (TKA) is the second most common inpatient surgery in the U.S. and Canada, and is associated with severe postoperative pain, limiting early ambulation and optimal functional recovery. Perioperative opioid use has been linked with many adverse outcomes including opioid dependence. This study aims to demonstrate the utility of CACB as an adjunct strategy to reduce opioid consumption and improve quality of recovery in primary knee arthroplasty patients. The innovation in this approach lies not only in less opioid consumption and opioid induced side effects but also in reducing the burden of postoperative pain, leading to an enhanced recovery and better quality of life. Establishing the safeness of this method in an outpatient setting may have the additional impact of decreasing health care costs and may lead to reduce opioid prescriptions on discharge from the hospital.
This will be the first study assessing patient's reported quality of recovery after receiving CACB for primary knee arthroplasties. Investigators expect that that the use of CACB will improve patients' quality of recovery, alleviate pain and also reduce opioid consumption and side effects.
Methodology
This will be a prospective, randomized double blind placebo controlled clinical trial. There will be two arms of treatment: intervention and control group. Preoperatively patients will be allocated at random to receive either Continuous adductor canal block (CACB) (intervention group) or sham continuous adductor canal block (ShACB) (control group).
Work Plan
This prospective trial would include unilateral primary TKA done under Fastrack protocol. The subjects will have their surgeries booked in advance and they will be submitted to the pre anesthesia consult at the Pre-Admission Unit a few days before the surgery. The study proposal will be explained to the patients at time of preadmission consult. They will receive a booklet with information about the study and the Consent Form that they will bring home with them. Patients will be randomized to one of the two groups using a computer-generated random numbers table. The elastomeric pumps to be used connected to the catheter will be previously prepared by hospital pharmacy, accordingly to the randomization made and the subject study number, with no identification of the content (NaCl 0.9% or Ropivacaine 0.2%). All patients will receive the same perioperative management. The only difference will be the postoperative continuous perineural infusion: the CACB group will receive an infusion of 0.2% ropivacaine 5mL/h and ShACB group will receive an infusion of NaCl 0.9% 5mL/h. Patients will initially be brought to a dedicated block room where a safety checklist will be performed by the block room team before performing the block. Standard Canadian Anesthesia Society monitoring will be provided. After surgery, the patient will be taken to the Post Anesthesia Care Unit. At this moment, an Arrow® (StimuCath® Continuous Peripheral Nerve Block Catheter) continuous adductor canal block catheter will be inserted using a Sonosite Edge II ultrasound machine. The patient may be discharged home after achieving the discharge criteria, keeping the peripheral nerve catheter with the same infusion rate for the planned time. The adductor canal catheter will infuse for 48 hours. Prior to going home, patients will receive education and written information (educational pamphlet) regarding monitoring for local anesthetic systemic toxicity symptoms, possible CABC associated complications including potential transient muscle weakness, and instructions on patient removal of the catheter after 48 hours. The study coordinator will collect the data once a day at 24, 48, 72 hrs, seven, 30 and 90 days postoperatively. Data collection will require at maximum 15 minutes.
Sample Size Sample size justification was based on the primary outcome, and the primary objective. The sample size was calculated based on previous study (12) that showed a 48-hour opioid consumption of 30mg (+/- 15 mg) morphine equivalents in knee replacement surgeries at our institute. Investigators anticipate a 50% decrease of opioid use in the intervention group with an alpha of 0.05, power of 80%, and an enrolment ratio of 1:1 (between the 2 groups). This will require 16 subjects in each group for a total of 32 patients. To compensate for 15 to 20% anticipated dropouts from the study, investigators plan for an inclusion of 40 patients.
- Conditions
- Total Knee Arthroplasty
- Being tested
- continuous adductor canal block (CACB) ropivacaine, sham continuous adductor canal block - ShACB NaCl
- Keywords
- Orthopaedic, Postoperative Pain Management, total knee arthroplasty, Continuous adductor canal block, Fast-track
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
continuous adductor canal block (CACB) ropivacaineDrug
The CACB group will receive an infusion of 0.2% ropivacaine 5mL/h
sham continuous adductor canal block - ShACB NaClDrug
sham continuous adductor canal block - ShACB and ShACB group will receive an infusion of NaCl 0.9% 5mL/h.
| Study group | Role | What they receive |
|---|---|---|
| CACB | Active comparator | continuous adductor canal block Receives: Drug: continuous adductor canal block (CACB) ropivacaine |
| Control group | Placebo comparator | sham continuous adductor canal block - ShACB Receives: Drug: sham continuous adductor canal block - ShACB NaCl |
What is being measured
The primary outcome is the main question the study is designed to answer.
opioid consumption
opioid consumption. Total opioid consumption changes will be assessed at 24, 48, 72 hours, seven, 30 and 90 days postoperatively.
Measured: At baseline, 24, 48, 72 hours, seven, 30 and 90 days postoperatively
Secondary outcomes (3)
Quality of Recovery
Quality of Recovery (via QoR-15) total score. Changes will be assessed via QoR-15 (Quality of Recovery). (From score 0 to 10, higher scores mean a better outcome .(At baseline, 24, 48, 72 hours, seven, 30 and 90 days postoperatively)
Measured: At baseline, 24, 48, 72 hours, seven, 30 and 90 days postoperatively
Intensity of postoperative pain
The intensity of postoperative pain. Changes will be assessed by Visual Analog Scale (VAS) at rest and movement once a day using a categorical pain scoring system. (From score 0 to 10, higher scores mean a worse outcome) (At baseline, 24, 48, 72 hours, seven, 30 and 90 days postoperatively)
Measured: At baseline, 24, 48, 72 hours, seven, 30 and 90 days postoperatively
Opioid related side effects
Opioid related side effects. Changes will be assessed using Opioid-related symptom Distress Scale (ORSDS). (At baseline, 24, 48, 72 hours, seven, 30 and 90 days postoperatively)
Measured: At baseline, 24, 48, 72 hours, seven, 30 and 90 days postoperatively
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted27 Jul 2023
- Study start4 Oct 2023
- Primary completion30 Dec 2025
- Study completion30 Dec 2025
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (12)Papers the sponsor has linked to this study.
- Other trials for Total Knee ArthroplastyStudies of the same condition, open and under way.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase N/A
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Quadruple blind
- Who is masked
- Participant, Care provider, Investigator, Outcomes assessor
- Enrolment
- 60 participants (actual)
Sponsor and investigators
- Lead sponsor
- Samuel Lunenfeld Research Institute, Mount Sinai Hospital
- Sponsor type
- University, hospital or other
- Responsible party
- Principal investigator, Dr. Naveed Siddiqui, Samuel Lunenfeld Research Institute, Mount Sinai Hospital
- Investigators
- Naveed Siddiqui, MD, Principal investigator, Associate Professor
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT05962970
- Sponsor's protocol ID
- 21-0041-A
- Acronym
- CACB
- Status last verified
- Jan 2025
- First submitted
- 8 Jun 2023
- Last updated
- 11 Jun 2026
- Results posted
- No
- Data monitoring committee
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- No
Publications
Price AJ, Alvand A, Troelsen A, Katz JN, Hooper G, Gray A, Carr A, Beard D. Knee replacement. Lancet. 2018 Nov 3;392(10158):1672-1682. doi: 10.1016/S0140-6736(18)32344-4.
PubMed 30496082Cullom C, Weed JT. Anesthetic and Analgesic Management for Outpatient Knee Arthroplasty. Curr Pain Headache Rep. 2017 May;21(5):23. doi: 10.1007/s11916-017-0623-y.
PubMed 28283810Wang J, Vahid S, Eberg M, Milroy S, Milkovich J, Wright FC, Hunter A, Kalladeen R, Zanchetta C, Wijeysundera HC, Irish J. Clearing the surgical backlog caused by COVID-19 in Ontario: a time series modelling study. CMAJ. 2020 Nov 2;192(44):E1347-E1356. doi: 10.1503/cmaj.201521. Epub 2020 Sep 1.
PubMed 32873541Ilfeld BM, Duke KB, Donohue MC. The association between lower extremity continuous peripheral nerve blocks and patient falls after knee and hip arthroplasty. Anesth Analg. 2010 Dec;111(6):1552-4. doi: 10.1213/ANE.0b013e3181fb9507. Epub 2010 Oct 1.
PubMed 20889937Sharma S, Iorio R, Specht LM, Davies-Lepie S, Healy WL. Complications of femoral nerve block for total knee arthroplasty. Clin Orthop Relat Res. 2010 Jan;468(1):135-40. doi: 10.1007/s11999-009-1025-1. Epub 2009 Aug 13.
PubMed 19680735Sankineani SR, Reddy ARC, Eachempati KK, Jangale A, Gurava Reddy AV. Comparison of adductor canal block and IPACK block (interspace between the popliteal artery and the capsule of the posterior knee) with adductor canal block alone after total knee arthroplasty: a prospective control trial on pain and knee function in immediate postoperative period. Eur J Orthop Surg Traumatol. 2018 Oct;28(7):1391-1395. doi: 10.1007/s00590-018-2218-7. Epub 2018 May 2.
PubMed 29721648Leung P, Dickerson DM, Denduluri SK, Mohammed MK, Lu M, Anitescu M, Luu HH. Postoperative continuous adductor canal block for total knee arthroplasty improves pain and functional recovery: A randomized controlled clinical trial. J Clin Anesth. 2018 Sep;49:46-52. doi: 10.1016/j.jclinane.2018.06.004. Epub 2018 Jun 8.
PubMed 29890381Yu R, Wang H, Zhuo Y, Liu D, Wu C, Zhang Y. Continuous adductor canal block provides better performance after total knee arthroplasty compared with the single-shot adductor canal block?: An updated meta-analysis of randomized controlled trials. Medicine (Baltimore). 2020 Oct 23;99(43):e22762. doi: 10.1097/MD.0000000000022762.
PubMed 33120783Hanson NA, Lee PH, Yuan SC, Choi DS, Allen CJ, Auyong DB. Continuous ambulatory adductor canal catheters for patients undergoing knee arthroplasty surgery. J Clin Anesth. 2016 Dec;35:190-194. doi: 10.1016/j.jclinane.2016.07.022. Epub 2016 Aug 30.
PubMed 27871518Myles PS. More than just morbidity and mortality - quality of recovery and long-term functional recovery after surgery. Anaesthesia. 2020 Jan;75 Suppl 1:e143-e150. doi: 10.1111/anae.14786.
PubMed 31903564Sun C, Zhang X, Song F, Zhao Z, Du R, Wu S, Ma Q, Cai X. Is continuous catheter adductor canal block better than single-shot canal adductor canal block in primary total knee arthroplasty?: A GRADE analysis of the evidence through a systematic review and meta-analysis. Medicine (Baltimore). 2020 May;99(20):e20320. doi: 10.1097/MD.0000000000020320.
PubMed 32443383Khan MI, Khandadashpoor S, Rai Y, Vertolli G, Backstein D, Siddiqui N. Comparing Analgesia on an As-Needed Basis to Traditional Intravenous Patient-Controlled Analgesia Within Fast-Track Orthopedic Procedures: A Randomized Controlled Trial. Pain Manag Nurs. 2022 Dec;23(6):832-837. doi: 10.1016/j.pmn.2022.04.003. Epub 2022 May 20.
PubMed 35599141
Study at a glance
From the registry record, last updated by the sponsor on 11 Jun 2026. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Continuous Adductor Canal Block in Fast Track Total Knee Arthroplasty
- ClinicalTrials.gov ID
- NCT05962970
- Acronym / sponsor ID
- CACB / 21-0041-A
- Conditions
- Total Knee Arthroplasty
- Keywords
- Orthopaedic, Postoperative Pain Management, total knee arthroplasty, Continuous adductor canal block, Fast-track
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 60 participants (actual)
- Lead sponsor
- Samuel Lunenfeld Research Institute, Mount Sinai HospitalUniversity, hospital or other
- Study start
- 4 Oct 2023 (actual)
- Primary completion
- 30 Dec 2025 (actual)
- Study completion
- 30 Dec 2025 (actual)
- First posted
- 27 Jul 2023 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
Total knee arthroplasty (TKA) is a frequent performed surgery. Many institutions are implementing fast track programs for this surgery and adequate pain management is an important feature. Analgesic duration of single shot nerve blocks is limited to no more than 24h. Conversely, the use of continuous nerve block (CNB) through a perineural catheter and infusion of local anesthetic may increase duration of analgesia and provide better outcomes. The purpose of this study is to evaluate effectiveness and safety of using CNB in patients undergoing ambulatory TKA, and its effects on patients' quality of recovery. Investigators hypothesize that continuous adductor canal block would lead to decrease in opioid consumption in patients undergoing fast track TKA.
Significance There are no published prospective randomized controlled trials to assess patient's reported quality of recovery after receiving CACB in same day primary knee arthroplasties. As this is a frequent type of surgery and has the prediction to increase its incidence for the next years, there is significant importance in investigations about interventions which may improve its recovery in a fast track regime. A postoperative analgesic technique that offers better pain control, has less adverse effects, reduces the opioid analgesia requirement and is safe to be used in a fast track setting may have additional impact on decreasing health care cost and may lead to an enhanced recovery and better quality of life.
Objectives To evaluate effectiveness and safety of using CACB in patients undergoing ambulatory TKA, in comparison to SACB. Primary objective is opioid consumption (in oral morphine equivalent doses) Secondary objectives are to evaluate postoperative QoR-15 scores (10), pain scores, opioid-induced adverse effects (measured via validated opioid symptom distress scale), postoperative functional status, complications relating to the perineural catheter and readmissions.
Detailed description
Objectives The aim of this study is to examine the effect of CACB on decreasing opioid consumption, increasing the Quality of Recovery (measured via QoR-15) total score and decreasing opioid-related side effects. Investigators will also assess the rate of readmissions in primary knee arthroplasty patients.
Rationale
Pain management in knee arthroplasty patients poses unique challenges for the anesthesiologist, especially in the immediate post-operative period. Early postoperative analgesia is limited to a unimodality of intravenous opioids. Recently, adductor canal blocks have started to replace femoral blocks, as this technique can provide similar analgesic results while avoiding the quadriceps muscle weakness associated with femoral nerve blocks. The use of a continuous adductor canal catheter in the post-discharge phase shows promising as the next step in knee arthroplasty pain management allowing for shorter lengths of stay or even same day discharge (3).
Significance and Innovation
Total knee arthroplasty (TKA) is the second most common inpatient surgery in the U.S. and Canada, and is associated with severe postoperative pain, limiting early ambulation and optimal functional recovery. Perioperative opioid use has been linked with many adverse outcomes including opioid dependence. This study aims to demonstrate the utility of CACB as an adjunct strategy to reduce opioid consumption and improve quality of recovery in primary knee arthroplasty patients. The innovation in this approach lies not only in less opioid consumption and opioid induced side effects but also in reducing the burden of postoperative pain, leading to an enhanced recovery and better quality of life. Establishing the safeness of this method in an outpatient setting may have the additional impact of decreasing health care costs and may lead to reduce opioid prescriptions on discharge from the hospital.
This will be the first study assessing patient's reported quality of recovery after receiving CACB for primary knee arthroplasties. Investigators expect that that the use of CACB will improve patients' quality of recovery, alleviate pain and also reduce opioid consumption and side effects.
Methodology
This will be a prospective, randomized double blind placebo controlled clinical trial. There will be two arms of treatment: intervention and control group. Preoperatively patients will be allocated at random to receive either Continuous adductor canal block (CACB) (intervention group) or sham continuous adductor canal block (ShACB) (control group).
Work Plan
This prospective trial would include unilateral primary TKA done under Fastrack protocol. The subjects will have their surgeries booked in advance and they will be submitted to the pre anesthesia consult at the Pre-Admission Unit a few days before the surgery. The study proposal will be explained to the patients at time of preadmission consult. They will receive a booklet with information about the study and the Consent Form that they will bring home with them. Patients will be randomized to one of the two groups using a computer-generated random numbers table. The elastomeric pumps to be used connected to the catheter will be previously prepared by hospital pharmacy, accordingly to the randomization made and the subject study number, with no identification of the content (NaCl 0.9% or Ropivacaine 0.2%). All patients will receive the same perioperative management. The only difference will be the postoperative continuous perineural infusion: the CACB group will receive an infusion of 0.2% ropivacaine 5mL/h and ShACB group will receive an infusion of NaCl 0.9% 5mL/h. Patients will initially be brought to a dedicated block room where a safety checklist will be performed by the block room team before performing the block. Standard Canadian Anesthesia Society monitoring will be provided. After surgery, the patient will be taken to the Post Anesthesia Care Unit. At this moment, an Arrow® (StimuCath® Continuous Peripheral Nerve Block Catheter) continuous adductor canal block catheter will be inserted using a Sonosite Edge II ultrasound machine. The patient may be discharged home after achieving the discharge criteria, keeping the peripheral nerve catheter with the same infusion rate for the planned time. The adductor canal catheter will infuse for 48 hours. Prior to going home, patients will receive education and written information (educational pamphlet) regarding monitoring for local anesthetic systemic toxicity symptoms, possible CABC associated complications including potential transient muscle weakness, and instructions on patient removal of the catheter after 48 hours. The study coordinator will collect the data once a day at 24, 48, 72 hrs, seven, 30 and 90 days postoperatively. Data collection will require at maximum 15 minutes.
Sample Size Sample size justification was based on the primary outcome, and the primary objective. The sample size was calculated based on previous study (12) that showed a 48-hour opioid consumption of 30mg (+/- 15 mg) morphine equivalents in knee replacement surgeries at our institute. Investigators anticipate a 50% decrease of opioid use in the intervention group with an alpha of 0.05, power of 80%, and an enrolment ratio of 1:1 (between the 2 groups). This will require 16 subjects in each group for a total of 32 patients. To compensate for 15 to 20% anticipated dropouts from the study, investigators plan for an inclusion of 40 patients.
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Quadruple blind (participant, care provider, investigator, outcomes assessor)
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| CACB | Active comparator | Drug: continuous adductor canal block (CACB) ropivacainecontinuous adductor canal block |
| Control group | Placebo comparator | Drug: sham continuous adductor canal block - ShACB NaClsham continuous adductor canal block - ShACB |
Who may qualify
- Ages
- 21 years and older
- Sex
- All
- Healthy volunteers
- Accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (5 listed)
- Patients undergoing unilateral primary TKA in the fast track setting.
- Patients older than 21 years of age, with American Society of Anesthesiologists (ASA)
- Physical status I-III
- No alcohol or drug dependency
- Sufficient understand and co-operation about the perineural catheter.
Key exclusion criteria (5 listed)
- Perioperative complication or discharge delay leading to hospital admission.
- Chronic opioid use of morphine 30mg equivalent per day for last 2 consecutive weeks.
- Allergy to the study medications;
- Coagulopathy and platelet count < 105/μL;
- Patients with contraindications to the insertion of an epidural or adductor canal catheter (severe anatomic abnormalities or history of previous surgery at the site of catheter placement).
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| continuous adductor canal block (CACB) ropivacaineThe CACB group will receive an infusion of 0.2% ropivacaine 5mL/h | Drug | CACB |
| sham continuous adductor canal block - ShACB NaClsham continuous adductor canal block - ShACB and ShACB group will receive an infusion of NaCl 0.9% 5mL/h. | Drug | Control group |
Primary outcome
opioid consumption
Time frame: At baseline, 24, 48, 72 hours, seven, 30 and 90 days postoperatively
opioid consumption. Total opioid consumption changes will be assessed at 24, 48, 72 hours, seven, 30 and 90 days postoperatively.
3 secondary outcomes
Quality of Recovery
Time frame: At baseline, 24, 48, 72 hours, seven, 30 and 90 days postoperatively
Intensity of postoperative pain
Time frame: At baseline, 24, 48, 72 hours, seven, 30 and 90 days postoperatively
Opioid related side effects
Time frame: At baseline, 24, 48, 72 hours, seven, 30 and 90 days postoperatively
Results and safety
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 11 Jun 2026.
- Background: PubMed 30496082Price AJ, Alvand A, Troelsen A, Katz JN, Hooper G, Gray A, Carr A, Beard D. Knee replacement. Lancet. 2018 Nov 3;392(10158):1672-1682. doi: 10.1016/S0140-6736(18)32344-4.
- Background: PubMed 28283810Cullom C, Weed JT. Anesthetic and Analgesic Management for Outpatient Knee Arthroplasty. Curr Pain Headache Rep. 2017 May;21(5):23. doi: 10.1007/s11916-017-0623-y.
- Background: PubMed 32873541Wang J, Vahid S, Eberg M, Milroy S, Milkovich J, Wright FC, Hunter A, Kalladeen R, Zanchetta C, Wijeysundera HC, Irish J. Clearing the surgical backlog caused by COVID-19 in Ontario: a time series modelling study. CMAJ. 2020 Nov 2;192(44):E1347-E1356. doi: 10.1503/cmaj.201521. Epub 2020 Sep 1.
- Background: PubMed 20889937Ilfeld BM, Duke KB, Donohue MC. The association between lower extremity continuous peripheral nerve blocks and patient falls after knee and hip arthroplasty. Anesth Analg. 2010 Dec;111(6):1552-4. doi: 10.1213/ANE.0b013e3181fb9507. Epub 2010 Oct 1.
- Background: PubMed 19680735Sharma S, Iorio R, Specht LM, Davies-Lepie S, Healy WL. Complications of femoral nerve block for total knee arthroplasty. Clin Orthop Relat Res. 2010 Jan;468(1):135-40. doi: 10.1007/s11999-009-1025-1. Epub 2009 Aug 13.
- Background: PubMed 29721648Sankineani SR, Reddy ARC, Eachempati KK, Jangale A, Gurava Reddy AV. Comparison of adductor canal block and IPACK block (interspace between the popliteal artery and the capsule of the posterior knee) with adductor canal block alone after total knee arthroplasty: a prospective control trial on pain and knee function in immediate postoperative period. Eur J Orthop Surg Traumatol. 2018 Oct;28(7):1391-1395. doi: 10.1007/s00590-018-2218-7. Epub 2018 May 2.
- Background: PubMed 29890381Leung P, Dickerson DM, Denduluri SK, Mohammed MK, Lu M, Anitescu M, Luu HH. Postoperative continuous adductor canal block for total knee arthroplasty improves pain and functional recovery: A randomized controlled clinical trial. J Clin Anesth. 2018 Sep;49:46-52. doi: 10.1016/j.jclinane.2018.06.004. Epub 2018 Jun 8.
- Background: PubMed 33120783Yu R, Wang H, Zhuo Y, Liu D, Wu C, Zhang Y. Continuous adductor canal block provides better performance after total knee arthroplasty compared with the single-shot adductor canal block?: An updated meta-analysis of randomized controlled trials. Medicine (Baltimore). 2020 Oct 23;99(43):e22762. doi: 10.1097/MD.0000000000022762.
- Background: PubMed 27871518Hanson NA, Lee PH, Yuan SC, Choi DS, Allen CJ, Auyong DB. Continuous ambulatory adductor canal catheters for patients undergoing knee arthroplasty surgery. J Clin Anesth. 2016 Dec;35:190-194. doi: 10.1016/j.jclinane.2016.07.022. Epub 2016 Aug 30.
- Background: PubMed 31903564Myles PS. More than just morbidity and mortality - quality of recovery and long-term functional recovery after surgery. Anaesthesia. 2020 Jan;75 Suppl 1:e143-e150. doi: 10.1111/anae.14786.
- Background: PubMed 32443383Sun C, Zhang X, Song F, Zhao Z, Du R, Wu S, Ma Q, Cai X. Is continuous catheter adductor canal block better than single-shot canal adductor canal block in primary total knee arthroplasty?: A GRADE analysis of the evidence through a systematic review and meta-analysis. Medicine (Baltimore). 2020 May;99(20):e20320. doi: 10.1097/MD.0000000000020320.
- Background: PubMed 35599141Khan MI, Khandadashpoor S, Rai Y, Vertolli G, Backstein D, Siddiqui N. Comparing Analgesia on an As-Needed Basis to Traditional Intravenous Patient-Controlled Analgesia Within Fast-Track Orthopedic Procedures: A Randomized Controlled Trial. Pain Manag Nurs. 2022 Dec;23(6):832-837. doi: 10.1016/j.pmn.2022.04.003. Epub 2022 May 20.
- Individual participant dataSharing planned: No
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Symptomatic Venous Thromboembolism (VTE)
Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
Naveed Siddiqui, MD principal investigator
Associate Professor
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing continuous adductor canal block (CACB) ropivacaine in people with Total Knee Arthroplasty, run by Samuel Lunenfeld Research Institute, Mount Sinai Hospital at 1 site in Canada.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 5 inclusion and 5 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: finished, as of the sponsor's last update on 11 Jun 2026. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in Canada. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. Some participants in this study may receive a placebo. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
opioid consumption (time frame: At baseline, 24, 48, 72 hours, seven, 30 and 90 days postoperatively). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
On the ClinicalTrials.gov record for NCT05962970, which also lists 12 linked publications.
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 11 Jun 2026.