Evaluation by Ultrasound Imaging of Local Anesthetic Spread to the Popliteal Fossa During an Adductor Canal Block

Knee Injuries Clinical Trial

— EchoCAdd  

Official title:

Evaluation by Ultrasound Imaging of Local Anesthetic Spread to the Popliteal Fossa During an Adductor Canal Block

Clinical Trial Details — Status: Recruiting

Administrative data

• NCT number: NCT06245460
• Other study ID #: APHP231771
• Secondary ID: 2023-A01774-41
• Status: Recruiting
• Start date: March 5, 2024
• Est. completion date: March 2026

Study information

• Verified date: April 2024
• Source: Assistance Publique - Hôpitaux de Paris
• Contact: Romuald Henry, MD
• Phone: + 33 1 71 16 77 44
• Email: romuald.henry[@]aphp.fr
• Is FDA regulated: No
• Study type: Observational

Clinical Trial Summary

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 the frequency of the spread of the adductor canal block to the fibular and tibial nerves assessed by ultrasound observation at the popliteal fossa.

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 ultrasound observation at the popliteal fossa.

Recruitment information / eligibility

• Status: Recruiting
• Enrollment: 100
• Est. completion date: March 2026
• Est. primary completion date: March 2026
• Accepts healthy volunteers: No
• Gender: All
• Age group: 18 Years and older

Eligibility

Inclusion Criteria:

• patients scheduled for elective knee surgery under general anesthesia

• in center of Ambroise Paré hospital

• 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

Related Conditions & MeSH terms

• Knee Injuries

Locations

Country	Name	City	State
France	Department of anesthesia, Ambroise Paré Hospital - APHP	Boulogne-Billancourt

Sponsors (1)

Lead Sponsor	Collaborator
Assistance Publique - Hôpitaux de Paris

Country where clinical trial is conducted

France, 

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Frequency of local anesthetic's spread	The primary outcome is the frequency of local anesthetic's spread to tibial and fibular nerve during an adductor canal block, assessed by ultrasound imaging at the popliteal fossa level. The ultrasound images will be recorded and then assessed by two independent anesthesiologists.	at baseline
Secondary	Frequency of altered sensibility	Frequency of altered sensibility and motricity in fibular and tibial nerves territories assessed at one and four hours after the adductor canal block has been performed.	at one and four hours
Secondary	Correlation between local anesthetic spread and clinical alteration	Correlation between local anesthetic spread to tibial and fibular nerves during adductor canal block assessed by ultrasound imaging and clinical alteration of sensibility and motricity in these nerves' territories.	at baseline, hour 1 and hour 4th