Comparison of Analgesic Effects of ACB Versus ACB Combined With BiFeS Block in Meniscopathy Surgery

May 27, 2026 updated by: Atakan Sezgi, Ankara Etlik City Hospital

Comparison of Analgesic Effects of Adductor Canal Block Versus Adductor Canal Block Combined With BiFeS (Biceps Femoris Short Head) Block in Meniscopathy Surgery

Meniscopathy surgeries are commonly associated with moderate postoperative pain, particularly during early mobilization and rehabilitation. Inadequate postoperative analgesia may negatively affect functional recovery, delay ambulation, increase opioid consumption, and contribute to opioid-related adverse effects. Therefore, effective multimodal analgesic strategies are of considerable importance in patients undergoing arthroscopic knee procedures.

Adductor canal block (ACB) is a widely used regional anesthesia technique that provides effective analgesia while largely preserving quadriceps muscle strength. However, its limited effect on posterior knee capsule innervation may result in insufficient control of posterior knee pain. Recently, the biceps femoris short head (BiFeS) block has been described as a novel motor-sparing fascial plane block targeting the posterolateral knee capsule and may provide additional analgesic benefit when combined with ACB.

In this study, it was aimed to compare the postoperative analgesic efficacy of adductor canal block alone and adductor canal block combined with BiFeS block in patients undergoing surgery for meniscopathy.

Study Overview

Study Type

Interventional

Enrollment (Estimated)

135

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Contact

Study Contact Backup

Study Locations

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Adult
  • Older Adult

Accepts Healthy Volunteers

No

Description

Inclusion Criteria:

  • Patients aged 18-65 years
  • American Society of Anesthesiologists (ASA) score I-II-III
  • Body Mass Index (BMI) between 18-30 kg/m2

Exclusion Criteria:

  • Patients under 18 and over 65 years of age
  • ASA score IV and above
  • Patients with a history of bleeding diathesis
  • BMI below 18 or above 30 kg/m2

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Treatment
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: Single

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Active Comparator: Adductor Canal Block Group
After the linear ultrasound probe is placed transversely over the mid-thigh on the side of surgery, the sartorius muscle, femoral artery, vastus medialis muscle, and adductor canal will be identified. The probe will be adjusted to obtain an optimal short-axis view of the femoral artery beneath the sartorius muscle. A block needle will then be advanced using an in-plane technique toward the adductor canal. After negative aspiration, 10 ml of 0.25% bupivacaine will be injected into the fascial plane adjacent to the femoral artery within the adductor canal. Proper spread of the local anesthetic around the femoral artery and beneath the sartorius muscle will be confirmed by ultrasound imaging.

Adductor canal block will be performed on the patients using 10 ml of 0.25% bupivacaine under ultrasound guidance.

Additionally, in the postoperative period a paracetamol dose of 1 g every 8 hours and a dexketoprofen dose of 50 mg twice daily were administered iv for multimodal analgesia.

Active Comparator: Adductor Canal Block + BiFeS (Biceps Femoris Short Head) Block Group
First, 10 ml of 0.25% bupivacaine will be injected into the adductor canal, and proper spread of the local anesthetic around the femoral artery and beneath the sartorius muscle will be confirmed by ultrasound imaging. Subsequently, the biceps femoris short head block will be performed under ultrasound guidance on the same side. The ultrasound probe will be positioned to identify the short head of the biceps femoris muscle and the lateral femoral cortex at the distal thigh/supracondylar region. A block needle will be advanced using an in-plane technique toward the fascial plane between the short head of the biceps femoris muscle and the lateral femoral cortex. After negative aspiration, 20 ml of 0.25% bupivacaine will be injected into this plane. Adequate spread of the local anesthetic along the interface between the biceps femoris short head and the femur will be confirmed by ultrasound imaging.

In the adductor canal block + BiFeS block group, adductor canal block will be performed using 10 ml of 0.25% bupivacaine, followed by BiFeS block using 20 ml of 0.25% bupivacaine under ultrasound guidance, with a total local anesthetic volume of 30 ml.

Additionally, in the postoperative period a paracetamol dose of 1 g every 8 hours and a dexketoprofen dose of 50 mg twice daily were administered iv for multimodal analgesia.

Active Comparator: Control Group
Participants in the control group will not receive any regional block intervention.
In the postoperative period a paracetamol dose of 1 g every 8 hours and a dexketoprofen dose of 50 mg twice daily were administered iv for multimodal analgesia.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Pain Scores
Time Frame: On the operation day
Pain will be assessed at rest and while coughing using the visual analog scale on a scale from 0 (no pain) to 100 (worst pain). Pain assessment will be done at 0st, 1st, 2nd,4th, 12th, and 24th hours after surgery.
On the operation day

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Total Postoperative Morphine Consumption During the First 24 Hours After Surgery
Time Frame: On the operation day
Total Postoperative Morphine Consumption During the First 24 Hours After Surgery
On the operation day

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

May 27, 2026

Primary Completion (Estimated)

May 7, 2027

Study Completion (Estimated)

May 21, 2027

Study Registration Dates

First Submitted

May 18, 2026

First Submitted That Met QC Criteria

May 18, 2026

First Posted (Actual)

May 22, 2026

Study Record Updates

Last Update Posted (Actual)

May 29, 2026

Last Update Submitted That Met QC Criteria

May 27, 2026

Last Verified

May 1, 2026

More Information

Terms related to this study

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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