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.
研究概览
研究类型
注册 (实际的)
阶段
- 不适用
联系人和位置
学习地点
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ABD Dışında
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Istanbul、ABD Dışında、土耳其（türkiye）、34400
- SBU Bagcilar Education and Training Hospital
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参与标准
资格标准
适合学习的年龄
- 成人
- 年长者
接受健康志愿者
描述
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.
学习计划
研究是如何设计的？
设计细节
- 主要用途：支持治疗
- 分配：随机化
- 介入模型：并行分配
- 屏蔽：三倍
武器和干预
参与者组/臂 |
干预/治疗 |
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有源比较器：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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有源比较器：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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研究衡量的是什么？
主要结果指标
结果测量 |
措施说明 |
大体时间 |
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Postoperative Pain Intensity
大体时间：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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次要结果测量
结果测量 |
措施说明 |
大体时间 |
|---|---|---|
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Postoperative Opioid Consumption
大体时间：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
大体时间：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
大体时间：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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合作者和调查者
研究记录日期
研究主要日期
学习开始 (实际的)
初级完成 (实际的)
研究完成 (实际的)
研究注册日期
首次提交
首先提交符合 QC 标准的
首次发布 (实际的)
研究记录更新
最后更新发布 (实际的)
上次提交的符合 QC 标准的更新
最后验证
更多信息
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