Adductor Canal Block With or Without Biceps Femoris Short Head Block in Total Knee Arthroplasty
Effect of Adding a Biceps Femoris Short Head Block to an Adductor Canal Block on Postoperative Pain and Functional Outcomes After Total Knee Arthroplasty: A Randomized Controlled Trial
Total knee arthroplasty is associated with moderate to severe postoperative pain, which may delay mobilization and recovery. Multimodal analgesia including regional anesthesia techniques is widely used to improve outcomes. The adductor canal block (ACB) provides anteromedial knee analgesia but may not adequately cover the posterolateral region.
The biceps femoris short head (BiFeS) block is a novel motor-sparing regional anesthesia technique targeting the posterolateral capsule of the knee. This randomized controlled trial aims to compare the analgesic efficacy and functional outcomes of ACB combined with BiFeS block versus ACB alone in patients undergoing total knee arthroplasty.
The primary outcome is posterior knee pain at postoperative 6 hours. Secondary outcomes include pain scores within 48 hours, opioid consumption, early and late functional recovery, and opioid-related adverse effects.
調査の概要
状態
条件
研究の種類
入学 (推定)
段階
- 適用できない
連絡先と場所
研究連絡先
- 名前:Demet Lafli Tunay, M.D.
- 電話番号:+905358685831
- メール:dlafli@yahoo.com
研究場所
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-
Saricam
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Adana、Saricam、トルコ(Türkiye)、01330
- Cukurova University
-
-
参加基準
適格基準
就学可能な年齢
- 大人
- 高齢者
健康ボランティアの受け入れ
説明
Inclusion Criteria:
- ASA I-III
- Adult patients undergoing unilateral primary TKA
- Planned spinal anesthesia
- Written informed consent
Exclusion Criteria:
- Coagulopathy
- Drug allergy
- BMI > 35
- Renal/hepatic failure
- Chronic pain or opioid use
- Depression or psychiatric disorder
- Revision or bilateral TKA
- Neurological deficits
- Preoperative ROM < 90°
研究計画
研究はどのように設計されていますか?
デザインの詳細
- 主な目的:処理
- 割り当て:ランダム化
- 介入モデル:並列代入
- マスキング:4倍
武器と介入
参加者グループ / アーム |
介入・治療 |
|---|---|
|
実験的:ACB + BiFeS
Participants receive spinal anesthesia followed by an ultrasound-guided adductor canal block and a biceps femoris short head block using local anesthetic for postoperative analgesia.
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Ultrasound-guided adductor canal block performed with injection of local anesthetic into the adductor canal to block the saphenous nerve and provide postoperative analgesia following total knee arthroplasty.
Ultrasound-guided biceps femoris short head block performed with injection of local anesthetic between the biceps femoris short head and femur to target the posterolateral innervation of the knee for postoperative analgesia.
|
|
アクティブコンパレータ:ACB + sham BiFeS
Participants receive spinal anesthesia followed by an ultrasound-guided adductor canal block and a sham biceps femoris short head block using normal saline.
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Ultrasound-guided adductor canal block performed with injection of local anesthetic into the adductor canal to block the saphenous nerve and provide postoperative analgesia following total knee arthroplasty.
Sham ultrasound-guided biceps femoris short head block performed with injection of normal saline at the same anatomical location to maintain blinding without providing active analgesia.
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この研究は何を測定していますか?
主要な結果の測定
結果測定 |
メジャーの説明 |
時間枠 |
|---|---|---|
|
Posterior Knee Pain Intensity
時間枠:6 hours postoperatively
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Posterior knee pain assessed using the Numeric Rating Scale (NRS, 0-10), where 0 indicates no pain and 10 indicates worst imaginable pain.
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6 hours postoperatively
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二次結果の測定
結果測定 |
メジャーの説明 |
時間枠 |
|---|---|---|
|
Postoperative Pain Intensity
時間枠:30 minutes, 1, 6, 12, 24, and 48 hours postoperatively
|
Pain intensity at rest and during movement assessed using the Numeric Rating Scale (NRS, 0-10).
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30 minutes, 1, 6, 12, 24, and 48 hours postoperatively
|
|
Total Opioid Consumption
時間枠:0-48 hours postoperatively
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Total opioid consumption measured from patient-controlled analgesia (PCA) device and additional opioid requirements, expressed in milligrams of morphine equivalent.
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0-48 hours postoperatively
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Rescue Analgesic Use
時間枠:0-48 hours postoperatively
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Requirement for additional analgesic medications (e.g., meperidine, paracetamol, ibuprofen) recorded as yes/no and total doses administered.
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0-48 hours postoperatively
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Functional Recovery
時間枠:24 hours, 48 hours, and 6 weeks postoperatively
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Functional recovery assessed by range of motion (ROM), quadriceps muscle strength, time to first ambulation, ability to walk 10 meters without assistance, and performance on the 5-times sit-to-stand test.
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24 hours, 48 hours, and 6 weeks postoperatively
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Quadriceps Muscle Strength
時間枠:Preoperatively, 24 hours, 48 hours, and 6 weeks postoperatively
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Quadriceps isometric muscle strength measured using a handheld dynamometer and expressed in Nm/kg.
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Preoperatively, 24 hours, 48 hours, and 6 weeks postoperatively
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Time to First Ambulation
時間枠:Within 48 hours postoperatively
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Time from the end of surgery to first successful ambulation, measured in hours.
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Within 48 hours postoperatively
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Patient Satisfaction
時間枠:48 hours postoperatively
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Patient satisfaction with postoperative pain management assessed using a 4-point scale (excellent, good, moderate, poor).
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48 hours postoperatively
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協力者と研究者
スポンサー
研究記録日
主要日程の研究
研究開始 (推定)
一次修了 (推定)
研究の完了 (推定)
試験登録日
最初に提出
QC基準を満たした最初の提出物
最初の投稿 (実際)
学習記録の更新
投稿された最後の更新 (実際)
QC基準を満たした最後の更新が送信されました
最終確認日
詳しくは
本研究に関する用語
追加の関連 MeSH 用語
その他の研究ID番号
- CU-BiFeS-2026
個々の参加者データ (IPD) の計画
個々の参加者データ (IPD) を共有する予定はありますか?
IPD プランの説明
医薬品およびデバイス情報、研究文書
米国FDA規制医薬品の研究
米国FDA規制機器製品の研究
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