Clinical Research Directory

Agreement Between Patient-Reported Pain, Observer-Rated Pain Behavior, and Analgesic Request After Total Knee Arthroplasty

The goal of this observational study is to learn how well patients' own pain ratings match what an observer sees and whether the patient asks for extra pain medicine after total knee replacement surgery. The study will include adults aged 18 years or older having planned (elective) total knee replacement under spinal anesthesia. The main questions it aims to answer are: * Does the pain score reported by the patient (Numeric Rating Scale, 0-10) agree with the patient's request for additional pain medicine? * Does the pain score reported by the patient agree with pain behavior rated by an observer (facial expression, body movements, and vocal expressions)? No treatment will be changed for this study. All patients will receive the hospital's standard anesthesia and pain management. Participants will: * Rate their pain from 0 (no pain) to 10 (worst pain imaginable) at 2, 6, and 24 hours after surgery * Be observed by a researcher who scores their pain behavior at the same time points * Be asked whether they would like additional pain medicine at each time point

Genicular Nerve Versus Adductor Canal Block for Postoperative Analgesia

Severe postoperative pain following total knee arthroplasty (TKA ) has been shown to negatively affect early mobilization, physical rehabilitation, time to discharge, and overall post-operative recovery.Therefore, reducing postoperative pain and early mobilization has become critical in reducing early mortality, preventing future chronic pain, and limiting the use of opioids The adductor canal block (ACB) has been found to be an excellent alternative to the FNB, providing adequate analgesia to the anterior knee compartment while enabling an improved postoperative range of motion by sparing motor branches to the quadriceps muscles . However, patients do not achieve adequate posterior knee analgesia as ACB pain relief is primarily limited to the anterior capsule of the knee. Genicular nerve block (GNB) and radiofrequency ablation of genicular nerves (RFGN) were originally introduced by Choi et al. as a therapeutic alternative for chronic knee OA and were quickly adopted for use in patients undergoing TKA due to the significant pain reduction and functional improvement observed in these patients . GNBs target five main innervating branches of the knee, including the superomedial, inferomedial, superolateral, inferolateral genicular nerves, and the infrapatellar branch of the saphenous nerve.

Postoperative Pain and Analgesic Use After Total Knee Arthroplasty

This prospective observational study evaluates postoperative pain intensity and analgesic consumption in patients undergoing total knee arthroplasty (TKA) under different anesthesia techniques. Patients receive either general anesthesia with peripheral nerve block, spinal anesthesia with peripheral nerve block, spinal anesthesia alone, or general anesthesia with an epidural catheter. Pain scores (NRS), analgesic use, adverse effects, patient satisfaction, and the need for therapeutic interventions are assessed during the first 48 hours after surgery. The study aims to identify differences in postoperative pain control and factors associated with hypotension and other complications.