Investigation of the Effect of Proximal and Distal Adductor Canal Block in Knee Replacement Surgery

Umraniye Education and Research Hospital

Status: Enrolling

Conditions: Knee Osteoarthritis

Treatments: Other: CONTROL GROUP; Other: ADDUKTOR CANAL BLOCK

Study type: Interventional

Funder types: Other

Identifiers

NCT06188806

URH-AR-ZT-06

Details and patient eligibility

About

to investigate the effect of adductor canal block applied with two different approaches in the treatment of pain after TKA surgery on pain control and functional mobility.

Full description

This prospective randomized trial is randomly divided into 3 groups using the method. Total knee arthroplasty is performed by the same surgical team.

is applied. The patients were divided into proximal ACB applied, distal ACB applied and control groups.

Enrollment: 78 estimated patients

Sex: All

Ages: 18 to 85 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Medications for unilateral TKA surgery

  • Patients aged 18-85
  • ASA 1-3

Exclusion criteria

• Patients under 18 years of age and over 85 years of age

• Patients with ASA 4 and above

• Patients with cognitive impairment

• Patients with application site infection

• Patients allergic to local anesthesia

• Patients receiving anticoagulant therapy

• Patients with bleeding diathesis

• Patients with chronic opioid or substance use

• Patients with insulin-dependent diabetes mellitus

• patients with neuropathy

  • patients with hepatic or renal failure

• Patients who do not accept the procedure to be applied

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: None (Open label)

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78 participants in 3 patient groups

PROXİMAL ADDUKTOR CANAL BLOCK GROUP

Active Comparator group

Description:

Patients are placed in the supine position and a high-frequency linear probe is inserted for a cross-sectional image of the groin and thigh. The femoral nerve is identified in the short axis near the inguinal crease and the ultrasound transducer is placed caudally beyond the femoral triangle. The location of the proximal block is determined where the superficial femoral artery passes under the medial border of the sartorius muscle (usually 8-12 cm distal to the inguinal crease). Using the in-plane technique, a 100 mm peripheral nerve block needle is advanced until the tip of the needle passes the sartorius muscle and enters the adductor canal from the lateral side of the superficial femoral artery, and 20 mL 0.375% Bupivacaine is administered. To verify block success, sensory function is assessed by pinprick testing along the saphenous nerve distribution by comparing the pinprick sensation to the unaffected limb.

Treatment:

Other: ADDUKTOR CANAL BLOCK

DİSTAL ADDUKTOR CANAL BLOCK GROUP

Active Comparator group

Description:

Patients are placed in the supine position, the mid-thigh point is determined as half the distance between the groin crease and the top of the patella. After the mid-thigh mark is marked with a sterile marking pen, the ultrasound transducer is positioned for a transverse view of the adductor canal into the mid-thigh. Under USG imaging, the femoral artery and saphenous nerve are identified. The distal position is determined where the USG probe moves away from the sartorius muscle of the femoral artery and proceeds deep into the adductor hiatus, and a 100 mm block needle passes the sartorius muscle with an in plane technique and 20 mL 0.375% Bupivacaine is administered to the lateral side of the femoral artery and saphenous nerve.

Treatment:

Other: ADDUKTOR CANAL BLOCK

CONTROL GROUP

Sham Comparator group

Description:

No nerve block procedure is applied to patients.

Treatment:

Other: CONTROL GROUP