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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.
Studie Overzicht
Toestand
Conditie
Studietype
Inschrijving (Geschat)
Fase
- Niet toepasbaar
Contacten en locaties
Studiecontact
- Naam: Demet Lafli Tunay, M.D.
- Telefoonnummer: +905358685831
- E-mail: dlafli@yahoo.com
Studie Locaties
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Saricam
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Adana, Saricam, Turkije (Türkiye), 01330
- Cukurova University
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Deelname Criteria
Geschiktheidscriteria
Leeftijden die in aanmerking komen voor studie
- Volwassen
- Oudere volwassene
Accepteert gezonde vrijwilligers
Beschrijving
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°
Studie plan
Hoe is de studie opgezet?
Ontwerpdetails
- Primair doel: Behandeling
- Toewijzing: Gerandomiseerd
- Interventioneel model: Parallelle opdracht
- Masker: Verviervoudigen
Wapens en interventies
Deelnemersgroep / Arm |
Interventie / Behandeling |
|---|---|
|
Experimenteel: 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.
|
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Actieve vergelijker: 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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Wat meet het onderzoek?
Primaire uitkomstmaten
Uitkomstmaat |
Maatregel Beschrijving |
Tijdsspanne |
|---|---|---|
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Posterior Knee Pain Intensity
Tijdsspanne: 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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Secundaire uitkomstmaten
Uitkomstmaat |
Maatregel Beschrijving |
Tijdsspanne |
|---|---|---|
|
Postoperative Pain Intensity
Tijdsspanne: 30 minutes, 1, 6, 12, 24, and 48 hours postoperatively
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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
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Total Opioid Consumption
Tijdsspanne: 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
Tijdsspanne: 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
Tijdsspanne: 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
Tijdsspanne: 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
Tijdsspanne: 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
Tijdsspanne: 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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Medewerkers en onderzoekers
Sponsor
Studie record data
Bestudeer belangrijke data
Studie start (Geschat)
Primaire voltooiing (Geschat)
Studie voltooiing (Geschat)
Studieregistratiedata
Eerst ingediend
Eerst ingediend dat voldeed aan de QC-criteria
Eerst geplaatst (Werkelijk)
Updates van studierecords
Laatste update geplaatst (Werkelijk)
Laatste update ingediend die voldeed aan QC-criteria
Laatst geverifieerd
Meer informatie
Termen gerelateerd aan deze studie
Trefwoorden
Aanvullende relevante MeSH-voorwaarden
Andere studie-ID-nummers
- CU-BiFeS-2026
Plan Individuele Deelnemersgegevens (IPD)
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Beschrijving IPD-plan
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