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.
Patients undergoing primary total knee arthroplasty under general anesthesia (laryngeal mask airway)
Fully autonomous at home
Planned discharge to home
Consent for participation
Preoperative opioid use
Chronic pain syndrome
Valgus contraindicating sciatic nerve block
Contraindication to any drugs used in the protocol