NCT06552897

Efficacy of Combined Adductor and Tibial Nerve Blocks for Pain Management in Knee Arthroplasty

A Randomized Controlled Trial Investigating the Efficacy of Combined Adductor Canal and Tibial Nerve Blocks for Enhanced Postoperative Pain Management in Knee Arthroplasty

• Status: Completed
• Phase: N/A
• Study type: Interventional
• Enrollment: 76 (actual)
• Sponsor: Ankara City Hospital Bilkent · Academic / Other
• Sex: All
• Age: 18 Years
• Healthy volunteers: Not accepted

Summary

This study aims to explore methods for enhancing pain relief following knee replacement surgery, a prevalent procedure for individuals with severe knee arthritis. Effective postoperative pain management is essential for ensuring a swift and comfortable recovery. Traditional pain management methods often involve medications that may have side effects; therefore, this study examines alternative approaches utilizing nerve blocks. Two pain management methods are compared in this study: Adductor Canal Block (ACB) Alone: A technique that numbs the anterior and medial regions of the knee. Combined Adductor Canal Block and Selective Tibial Nerve Block (ACB + STNB): An innovative approach that includes an additional block to numb the posterior aspect of the knee. The objective is to determine whether the combined approach offers superior pain relief, reduces the reliance on pain medications, and enhances overall postoperative recovery. Participants are randomly assigned to one of the two groups and receive the nerve blocks during their surgery. This study aspires to contribute to the development of improved pain management strategies, facilitating quicker and more comfortable recovery for patients undergoing knee replacement surgery.

Detailed description

Total knee arthroplasty (TKA), or knee replacement surgery, is a highly effective treatment for severe knee arthritis, providing significant pain relief and improved joint function. However, managing postoperative pain remains a significant challenge. Effective pain control is essential for facilitating early mobilization, reducing complications, and enhancing overall recovery. Traditional pain management often relies heavily on opioids, which can cause side effects such as nausea, dizziness, and dependency. To address these concerns, regional anesthesia techniques, including nerve blocks, are increasingly utilized to provide targeted pain relief while minimizing opioid use. This study evaluates the effectiveness of two nerve block techniques in managing postoperative pain following TKA: Adductor Canal Block (ACB): This technique targets nerves in the adductor canal, primarily affecting the saphenous nerve, which provides sensation to the anterior and medial regions of the knee. ACB is recognized for preserving muscle strength, thereby facilitating early mobility. Combined Adductor Canal Block and Selective Tibial Nerve Block (ACB + STNB): This approach incorporates a tibial nerve block to address the posterior aspect of the knee, aiming to provide comprehensive pain relief to both the anterior and posterior regions of the knee. The study is a prospective, randomized controlled trial involving 76 patients undergoing TKA at Health Sciences University Ankara City Hospital. Participants are randomly assigned to receive either the ACB alone or the combined ACB + STNB. Objectives: To assess the effectiveness of the combined ACB + STNB in reducing postoperative pain compared to ACB alone. To evaluate the impact on opioid consumption and overall patient satisfaction. To monitor potential side effects and the time to first additional analgesic requirement. Methods: Pain is measured using the Visual Analog Scale (VAS) at multiple time points after surgery. The study also records total analgesic consumption via patient-controlled analgesia (PCA). Secondary outcomes include side effects and patient satisfaction scores. The findings of this study could influence future pain management strategies for knee replacement surgeries, potentially offering patients a safer and more effective method for managing postoperative pain with fewer side effects.

Conditions

• Postoperative Pain Management
• Total Knee Arthroplasty
• Regional Anesthesia
• Nerve Blocks

Interventions

Type	Name	Description
PROCEDURE	Intervention 1: Adductor Canal Block (ACB)	For the Interventions section, you should describe the specific procedures or treatments administered in each arm of your study. Here's how you might present the interventions: Intervention 1: Adductor Canal Block (ACB) Name: Adductor Canal Block (ACB) Type: Procedure Description: Participants receive an ultrasound-guided adductor canal block. Dose and Administration: 20 ml of 0.25% bupivacaine is injected to target the saphenous nerve within the adductor canal. Objective: To provide analgesia to the anterior and medial aspects of the knee, preserving motor function to facilitate early mobilization.
PROCEDURE	Intervention 2: Combined Adductor Canal Block and Selective Tibial Nerve Block (ACB + STNB)	Name: Combined Adductor Canal Block and Selective Tibial Nerve Block (ACB + STNB) Type: Procedure Description: Participants receive an ultrasound-guided adductor canal block followed by a selective tibial nerve block. Dose and Administration: Adductor Canal Block (ACB): 20 ml of 0.25% bupivacaine. Selective Tibial Nerve Block (STNB): 20 ml of 0.25% bupivacaine. Objective: To provide comprehensive analgesia to both the anterior and posterior aspects of the knee, aiming to enhance pain relief and reduce opioid consumption.

Timeline

• Start date: 2022-05-01
• Primary completion: 2022-12-31
• Completion: 2022-12-31
• First posted: 2024-08-14
• Last updated: 2024-09-05

Locations

1 site across 1 country: Turkey (Türkiye)