Effect of Adding Vastus Medialis Nerve Block to Adductor Canal Block After Anterior Cruciate Ligament Reconstruction (VAMA)
Effect of Adding Vastus Medialis Nerve Block to Adductor Canal Block on Postoperative Analgesia Following Anterior Cruciate Ligament Reconstruction: A Prospective Randomized Controlled Trial
Anterior cruciate ligament (ACL) reconstruction is frequently associated with moderate to severe postoperative pain, which can delay mobilization and rehabilitation. The adductor canal block (ACB) is widely used for postoperative pain management because it provides effective analgesia while preserving quadriceps muscle strength. However, pain originating from the medial aspect of the knee may not be adequately controlled with ACB alone because the nerve to the vastus medialis may not be consistently anesthetized.
This prospective randomized controlled trial evaluates whether adding a vastus medialis nerve block (VMNB) to a standard adductor canal block improves postoperative pain control in patients undergoing elective arthroscopic ACL reconstruction. Participants are randomly assigned to receive either ACB alone or ACB combined with VMNB before surgery, while all patients receive the same standardized general anesthesia, surgical technique, and postoperative analgesic regimen.
The primary outcome is postoperative pain intensity measured using the Visual Analog Scale (VAS) at 1, 6, 12, and 24 hours after surgery. Secondary outcomes include postoperative opioid consumption, time to first mobilization, length of hospital stay, and block-related complications. The results of this study may help determine whether the addition of a vastus medialis nerve block provides clinically meaningful benefits and may contribute to improving postoperative pain management following ACL reconstruction.
調査の概要
研究の種類
入学 (実際)
段階
- 適用できない
連絡先と場所
研究場所
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ABD Dışında
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Istanbul、ABD Dışında、トルコ（Türkiye）、34400
- SBU Bagcilar Education and Training Hospital
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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:
- Adults aged 18 to 65 years.
- Scheduled for elective primary arthroscopic anterior cruciate ligament (ACL) reconstruction.
- American Society of Anesthesiologists (ASA) physical status I or II.
- Ability to provide written informed consent.
Exclusion Criteria:
- Previous surgery on the ipsilateral knee.
- Bilateral knee surgery.
- Coagulopathy or ongoing anticoagulant therapy contraindicating regional anesthesia.
- Peripheral neuropathy or neuromuscular disease.
- Local infection at the block injection site.
- Known allergy or hypersensitivity to amide local anesthetics.
- Contraindication to regional anesthesia.
- Refusal to participate in the study.
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：支持療法
- 割り当て：ランダム化
- 介入モデル：並列代入
- マスキング：トリプル
武器と介入
参加者グループ / アーム |
介入・治療 |
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アクティブコンパレータ：Adductor Canal Block
Participants received an ultrasound-guided adductor canal block before elective arthroscopic anterior cruciate ligament reconstruction.
All participants received standardized general anesthesia and postoperative analgesic management.
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An ultrasound-guided adductor canal block was performed before induction of general anesthesia using 15-20 mL of 0.25% bupivacaine as part of the multimodal analgesia protocol for anterior cruciate ligament reconstruction.
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アクティブコンパレータ：Adductor Canal Block Plus Vastus Medialis Nerve Block
Participants received an ultrasound-guided adductor canal block combined with an ultrasound-guided vastus medialis nerve block before elective arthroscopic anterior cruciate ligament reconstruction.
All participants received standardized general anesthesia and postoperative analgesic management.
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An ultrasound-guided adductor canal block was performed before induction of general anesthesia using 15-20 mL of 0.25% bupivacaine as part of the multimodal analgesia protocol for anterior cruciate ligament reconstruction.
An ultrasound-guided vastus medialis nerve block was performed before induction of general anesthesia using 5-10 mL of 0.25% bupivacaine in addition to the adductor canal block.
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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 |
|---|---|---|
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Postoperative Pain Intensity
時間枠：24 hours after surgery
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Postoperative pain intensity will be assessed using the 10-cm Visual Analog Scale (VAS) at rest at 1, 6, 12, and 24 hours after surgery.
VAS scores range from 0 (no pain) to 10 (worst imaginable pain).
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24 hours after surgery
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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 |
|---|---|---|
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Postoperative Opioid Consumption
時間枠：24 hours after surgery
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Total opioid consumption during the first 24 postoperative hours will be calculated as intravenous morphine equivalent dose (mg).
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24 hours after surgery
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Time to First Mobilization
時間枠：24 hours after surgery
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Time from completion of surgery to the patient's first successful ambulation, recorded in hours.
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24 hours after surgery
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Length of Hospital Stay
時間枠：24 hours after surgery
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Length of postoperative hospital stay measured in hours from the end of surgery until hospital discharge.
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24 hours after surgery
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協力者と研究者
研究記録日
主要日程の研究
研究開始 (実際)
一次修了 (実際)
研究の完了 (実際)
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
この情報は、Web サイト clinicaltrials.gov から変更なしで直接取得したものです。研究の詳細を変更、削除、または更新するリクエストがある場合は、register@clinicaltrials.gov。 までご連絡ください。 clinicaltrials.gov に変更が加えられるとすぐに、ウェブサイトでも自動的に更新されます。