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

Knee Osteoarthritis Clinical Trial

Official title: Investigation of the Effect of Proximal and Distal Adductor Canal Block on Pain Control and Functional Mobility in Total Knee Prosthesis Surgery Performed Under Spinal Anesthesia

Status Recruiting

Clinical Trial Summary

Adductor canal block is a popular peripheral nerve block that has been shown to significantly reduce post-TKA pain and reduce opioid consumption with minimal impact on quadriceps muscle strength. Several studies have documented that ACB is better than femoral nerve block in terms of preservation of postoperative quadriceps muscle strength, postoperative ambulation, and functional recovery without any change in pain control. ACB involves injection of local anesthetic into the adductor canal, a fascial compartment bounded by the sartorius, adductor longus, and vastus medialis muscles and traditionally identified as containing the saphenous nerve. However, the ideal location for adductor canal block to maximize analgesia while minimizing quadriceps weakness after knee surgery is unclear. In different studies, the advantages of proximal and distal positioning have been compared. The aim of the study is 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. Our hypothesis is that there will be a decrease in opioid use, early mobilization and a shortening of the hospital stay in patients with ACB.

Clinical Trial Description

It is applied with two different approaches in the treatment of pain after Total Knee Arthroplasty (TKA). In this methodological clinical research study conducted to investigate the postoperative effects of adductor canal block, our hypothesis is that there will be a decrease in opioid use, earlier mobilization, and a shortening of the hospital stay in patients with adductor canal block. This prospective randomized procedural clinical research study; It will be held at the Anesthesiology and Reanimation Clinic of Ümraniye Training and Research Hospital. Each patient is informed about the procedures to be applied during anesthesia and surgery. Signed informed consent is obtained before the procedure. All patients who will participate in the study will be sent in sealed envelopes. The patients are 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. are divided into 3 groups. Group 1: proximal ACB (n:26) - Group 2: distal ACB (n:26) - Group 3: Control group (n:26) Criteria for inclusion in the study; ASA 1-3 patients between the ages of 18-85 who will undergo unilateral TKA surgery. Exclusion criteria; Under 18 and over 85 years of age, ASA 4 and above, cognitive patients with a medical disorder, infection at the application site, allergy to local anesthesia, receiving anticoagulant treatment, bleeding diathesis, chronic opioid or substance use, Patients with insulin-dependent diabetes mellitus, neuropathy, hepatic or renal failure and those who do not accept the procedure to be applied The primary purpose of the study is; Postoperative pain level of adductor canal block applied preoperatively from different locations in patients undergoing TKA, opioid The aim of this study is to investigate the effect on need, mobilization time and hospital stay. secondary purpose adverse events that may occur after the blocks (motor block, nerve damage, hypotension, bradycardia, nausea and vomiting). ;

Related Conditions & MeSH terms

• Knee Osteoarthritis
• Osteoarthritis
• Osteoarthritis, Knee

• NCT number: NCT06188806
• Study type: Interventional
• Source: Umraniye Education and Research Hospital
• Contact: Zeliha TUNCEL
• Phone: +90 505 357 74 83
• Email: zelihalara@yahoo.com
• Status: Recruiting
• Phase: N/A
• Start date: November 10, 2023
• Completion date: August 10, 2024