Adductor Canal Block Methods in Bilateral Total Knee Arthroplasty

Официальное название

Comparison of Surgeon-Performed Intraoperative Adductor Canal Block and Ultrasound-Guided Anesthesiologist-Performed Block in Bilateral Total Knee Arthroplasty

Обзор

This study aims to compare the analgesic efficacy of surgeon-performed intraoperative adductor canal block (ACB) and ultrasound-guided anesthesiologist-performed ACB in patients undergoing bilateral total knee arthroplasty (TKA). In a prospective, randomized paired design, each patient will receive surgeon-performed ACB on one knee and anesthesiologist-performed ACB on the contralateral knee. The primary outcome is postoperative pain measured using the Numeric Rating Scale (NRS), and the study is designed to evaluate the non-inferiority of surgeon-performed ACB. Secondary outcomes include opioid consumption, time to first ambulation, length of hospital stay, postoperative complications, and patient-reported outcome measures (PROMs). Additionally, postoperative ultrasound evaluation will be performed to assess the distribution pattern of local anesthetic within the adductor canal, including cross-sectional area and longitudinal spread. This study is expected to provide evidence regarding the clinical effectiveness and technical accuracy of surgeon-performed ACB in comparison with the conventional ultrasound-guided technique.

Вмешательства

• Биопрепарат Surgeon-Performed Adductor Canal Block
  An adductor canal block performed intraoperatively by the surgeon using an anatomical landmark-based technique. The injection is administered at approximately 8 cm proximal to the distal femur, with the needle directed medially and posteriorly. A total of 20 mL of 0.3% ropivacaine mixed with epinephrine is injected using a standardized approach without ultrasound guidance.
• Биопрепарат Ultrasound-Guided Adductor Canal Block
  An adductor canal block performed by an anesthesiologist under ultrasound guidance. The saphenous nerve and femoral artery within the adductor canal are identified using real-time imaging, and 20 mL of 0.3% ropivacaine mixed with epinephrine is injected using an in-plane technique.

Первичные конечные точки

• Pain (Numeric Rating Scale) [Срок оценки: Baseline, postoperative day 0 (afternoon), postoperative day 1 (morning and afternoon), and postoperative day 2 (morning)]

Критерии участия

Критерии включения

• Adult patients aged 19 years or older
• Patients scheduled for bilateral total knee arthroplasty
• Patients who provide written informed consent

Критерии исключения

• Refusal to participate or inability to provide informed consent
• Neurological or psychiatric conditions affecting cooperation (e.g., dementia, delirium)
• Pre-existing neurological or anatomical abnormalities of the lower extremities
• Chronic opioid use or opioid dependence
• Coagulation disorders or contraindications to nerve block
• Pregnancy
• Cases in which ultrasound evaluation is technically not feasible

Критерии приведены из реестра в оригинале (на английском). Окончательную оценку соответствия проводит исследовательский центр.

Здоровые добровольцы: Нет

Дизайн исследования

Распределение

Рандомизированное

Модель

Параллельные группы

Маскирование

Открытое

Основная цель

Лечение

Центры проведения

Список центров уточняется — проверьте первичный протокол.

Идентификаторы

NCT: NCT07506629 · 4-2026-0060

Первоисточники (государственные реестры)

• ClinicalTrials.gov (NIH, США)

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