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Local Infiltration Analgesia Versus Quadruple Nerve Blocks in Total Knee Arthroplasty.
Sponsor: CMC Ambroise Paré
Summary
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.
Official title: Local Infiltration Analgesia Versus Quadruple Nerve Blocks in Total Knee Arthroplasty: a Randomized Controlled Trial.
Key Details
Gender
All
Age Range
18 Years - Any
Study Type
INTERVENTIONAL
Enrollment
80
Start Date
2026-06-01
Completion Date
2028-02-01
Last Updated
2026-03-17
Healthy Volunteers
No
Conditions
Interventions
Surgical local infiltration
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
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
Injection of 15 mL of 0.1% ropivacaine under the fascia iliaca, with the patient in supine position
Sciatic nerve block
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
Injection of 5 mL of 0.1% ropivacaine lateral to the sartorius muscle
Locations (1)
Clinique Médipôle Garonne
Toulouse, Haute-Garonne, France