Sciatic nerve block or not for outpatient total knee arthroplasty? Study protocol for a randomized controlled trial

Area of Science:

• Orthopedic Surgery
• Anesthesiology
• Pain Management

Background:

• Total knee arthroplasty (TKA) is increasingly performed worldwide.
• Outpatient TKA, with a hospital stay under 12 hours, requires effective pain and complication management for safe discharge.
• Multimodal protocols, including nerve blocks, are crucial for successful outpatient TKA.

Purpose of the Study:

• To assess the benefits of a single-shot sciatic nerve block in conjunction with a continuous femoral nerve block for postoperative pain relief in outpatient TKA.
• To evaluate the impact of this combined nerve block protocol on the success rate of same-day surgical discharge to a rehabilitation center.

Main Methods:

• A randomized prospective controlled study involving 40 patients undergoing primary unilateral outpatient TKA.
• Patients received a continuous femoral nerve block preoperatively.
• Patients were randomly assigned to receive an additional single-shot sciatic nerve block or not.

Main Results:

• The primary outcome is the success rate of outpatient TKA, defined by discharge to a rehabilitation center on the day of surgery with no re-hospitalization for pain control before postoperative day five.
• Secondary outcomes include the incidence of adverse events and quality of recovery assessments using validated questionnaires.

Conclusions:

• Assessing anesthesia and rehabilitation protocols is vital for major orthopedic procedures like TKA.
• This study hypothesizes that incorporating a sciatic nerve block into a multimodal protocol can enhance pain control, thereby improving the success of outpatient TKA.