Local Infiltration Analgesia Versus Quadruple Nerve Blocks in Total Knee Arthroplasty.

Sponsor
CMC Ambroise Paré
Study ID
NCT07477730
Status
Not Yet Recruiting

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Conditions

  • Total Knee Arthroplasty

Eligibility Criteria

Sex
ALL
Age
18 Years - N/A
Healthy Volunteers
Not accepted

Interventions

  • Surgical local infiltration — PROCEDURE
    Injection of 150 mL of ropivacaine 0.2% into periarticular tissues according to a standardized sequence, including the posterior capsule, collateral ligaments, quadriceps, patellar tendon, capsule and subcutaneous tissue before wound closure
  • Obturator nerve block — PROCEDURE
    Injection of 20 mL of 0.1% ropivacaine between the adductor magnus and adductor brevis muscles and between the adductor brevis and pectineus muscles
  • Femoral nerve block — PROCEDURE
    Injection of 15 mL of 0.1% ropivacaine under the fascia iliaca, with the patient in supine position
  • Sciatic nerve block — PROCEDURE
    Injection of 20 mL of 0.1% ropivacaine in the subgluteal space via a lateral approach, with the patient in prone position
  • Lateral femoral cutaneous nerve block — PROCEDURE
    Injection of 5 mL of 0.1% ropivacaine lateral to the sartorius muscle

Study Details

Total knee arthroplasty (TKA) is one of the most common orthopedic surgical procedures and is associated with severe pain in the immediate postoperative period, thus limiting early recovery. Optimal postoperative pain management after TKA is not fully defined. While multimodal analgesia is standard, the choice of associated regional anesthesia techniques is debated. Local infiltration analgesia (LIA) is widely used and provides effective pain relief without impairing early mobilization. Peripheral nerve blocks have been discussed due to the risk of motor blockade, but low-concentration local anesthetics, such as 0.1% ropivacaine, allow sensory blockade while preserving motor function. Preliminary studies suggest that this concentration is effective and safe. The main objective of this monocenter, prospective, randomized, open-label, controlled trial is to compare the analgesic efficacy of a quadruple nerve blocks (femoral, sciatic, obturator, and lateral femoral cutaneous nerves) using 0.1% ropivacaine versus standard LIA in patients undergoing TKA.

Key Dates

First listed
Mar 17, 2026
Start date
Jun 1, 2026
Status verified
Mar 2026
Primary completion
Dec 2, 2027
Completion
Feb 1, 2028

Study Design

Enrollment
80 participants (estimated)
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
OTHER

Arms

  • Active Comparator: LIA group
    Local infiltration analgesia
  • Experimental: Quadruple nerve blocks group
    Femoral, sciatic, obturator and lateral femoral cutaneous nerve blocks

Primary Outcome Measure

Total opioid consumption within 24 hours [ Time Frame: From start of surgery (t0) to 24 hours postoperatively ]

Central Contacts

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