Flex Appeal: Evaluating the Efficacy of Anesthetic Techniques for Manipulation of Knees Under Anesthesia

Inclusion:

• Patients ≥18 years presenting for a manipulation of knee joint under anesthesia.
• ASA Classification I - III.
• English speaking patients.

Exclusion:

• ASA 4 or 5
• Daily chronic opioid use (over 3 months of continuous opioid use).
• Inability to communicate pain scores or need for analgesia.
• Infection at the site of block placement
• Age under 18 years old or greater than 75 years old
• Pregnant women (as determined by point-of-care serum bHCG)
• Intolerance/allergy to local anesthetics
• Weight <50 kg
• Suspected, or known addiction to or abuse of illicit drug(s), prescription medicine(s), or alcohol within the past 2 years.
• Uncontrolled anxiety, schizophrenia, or other psychiatric disorder that, in the opinion of the investigator, may interfere with study assessments or compliance.
• Current or historical evidence of any clinically significant disease or condition that, in the opinion of the investigator, may increase the risk of surgery or complicate the subject's postoperative course.
• BMI >50 kg/m2.
• Allergy or contraindication to local anesthetics or any component of the multimodal analgesic regimen

(NSAIDs and acetaminophen)

• Contraindication to spinal injection