Evaluation of Local Anesthetic Diffusion to the Sciatic Nerve During Adductor Canal Block (DiffuCAdd)

Assistance Publique - Hôpitaux de Paris

Status: Enrolling

Conditions: Sciatic Nerve; Adductor Canal Syndrome

Study type: Observational

Funder types: Other

Identifiers

NCT07301476

APHP250730

2025-A00945-44 (Registry Identifier)

Details and patient eligibility

About

Adductor canal block is an effective analgesic technique for major knee surgery. However, the saphenous nerve block is not sufficient to explain this block's efficiency. It has been shown that adductor canal block can spread to the tibial and fibular nerves through the adductor hiatus. However, this diffusion's frequency has never been measured. The main objective of this study is to assess clinically the frequency of the spread of the adductor canal block to the fibular and tibial nerves.

Full description

Adductor canal block is an effective analgesic technique for major knee surgery. The PROSPECT group recommends this block in first intention for locoregional anesthesia in total knee arthroplasty. It has been shown to not be inferior to femoral nerve block in this indication.

The adductor canal block targets the saphenous nerve and, through its spread in the adductor canal, the posterior branch of obturator nerve and the vastus medialis nerve. However, these nerves can't fully explain this block's efficiency.

It has been shown that local anesthetic can spread in the adductor canal to the tibial and fibular nerves through the adductor hiatus. However, this spread is inconstant, and no study has evaluated the frequency of this spread yet.

The main objective of this study is to assess the diffusion's frequency of adductor canal block to fibular and tibial nerves through clinical sensorimotor testing.

Enrollment: 70 estimated patients

Sex: All

Ages: 18+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• patients over 18 years old scheduled for elective knee surgery under general anesthesia
• in our center
• receiving an adductor canal block

Exclusion criteria

• patients cognitively impaired,
• patients suffering from peripheral neuropathy at the lower limb,
• patients receiving an IPACK block or surgical knee infiltration to complete the adductor canal block analgesia.
• patients who refused to take part in this study
• pregnant or breastfeeding patients
• patients under guardianship
• imprisoned patients,
• patients without any medical insurance