Adductor Canal Block With or Without Biceps Femoris Short Head Block in Total Knee Arthroplasty

Официальное название

Effect of Adding a Biceps Femoris Short Head Block to an Adductor Canal Block on Postoperative Pain and Functional Outcomes After Total Knee Arthroplasty: A Randomized Controlled Trial

Обзор

Total knee arthroplasty is associated with moderate to severe postoperative pain, which may delay mobilization and recovery. Multimodal analgesia including regional anesthesia techniques is widely used to improve outcomes. The adductor canal block (ACB) provides anteromedial knee analgesia but may not adequately cover the posterolateral region. The biceps femoris short head (BiFeS) block is a novel motor-sparing regional anesthesia technique targeting the posterolateral capsule of the knee. This randomized controlled trial aims to compare the analgesic efficacy and functional outcomes of ACB combined with BiFeS block versus ACB alone in patients undergoing total knee arthroplasty. The primary outcome is posterior knee pain at postoperative 6 hours. Secondary outcomes include pain scores within 48 hours, opioid consumption, early and late functional recovery, and opioid-related adverse effects.

Вмешательства

• Процедура Adductor Canal Block
  Ultrasound-guided adductor canal block performed with injection of local anesthetic into the adductor canal to block the saphenous nerve and provide postoperative analgesia following total knee arthroplasty.
• Процедура Biceps Femoris Short Head Block
  Ultrasound-guided biceps femoris short head block performed with injection of local anesthetic between the biceps femoris short head and femur to target the posterolateral innervation of the knee for postoperative analgesia.
• Процедура Sham Biceps Femoris Short Head Block
  Sham ultrasound-guided biceps femoris short head block performed with injection of normal saline at the same anatomical location to maintain blinding without providing active analgesia.

Первичные конечные точки

• Posterior Knee Pain Intensity [Срок оценки: 6 hours postoperatively]

Вторичные конечные точки (7)

• Postoperative Pain Intensity [Срок оценки: 30 minutes, 1, 6, 12, 24, and 48 hours postoperatively]
• Total Opioid Consumption [Срок оценки: 0-48 hours postoperatively]
• Rescue Analgesic Use [Срок оценки: 0-48 hours postoperatively]
• Functional Recovery [Срок оценки: 24 hours, 48 hours, and 6 weeks postoperatively]
• Quadriceps Muscle Strength [Срок оценки: Preoperatively, 24 hours, 48 hours, and 6 weeks postoperatively]
• Time to First Ambulation [Срок оценки: Within 48 hours postoperatively]
• Patient Satisfaction [Срок оценки: 48 hours postoperatively]

Критерии участия

Критерии включения

• ASA I-III
• Adult patients undergoing unilateral primary TKA
• Planned spinal anesthesia
• Written informed consent

Критерии исключения

• Coagulopathy
• Drug allergy
• BMI > 35
• Renal/hepatic failure
• Chronic pain or opioid use
• Depression or psychiatric disorder
• Revision or bilateral TKA
• Neurological deficits
• Preoperative ROM < 90°

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

Четверное слепое

Основная цель

Лечение

Центры проведения

Turkey (Türkiye) · 1 центр

• Cukurova University — Adana

Идентификаторы

NCT: NCT07568106 · CU-BiFeS-2026

Первоисточники (государственные реестры)

• ClinicalTrials.gov (NIH, США)

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