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Arthroplasty, Replacement, KneePhase 4NCT04768764

Comparison Of Femoral Block And Middle Adductor Canal Block In Patients With Knee Arthroplasty

A Phase 4 study testing Ultrasound Guided Middle Adductor Canal Block, Ultrasound Guided Femoral Nerve Block. and Bupivacain in people with Arthroplasty, Replacement, Knee and Pain, Postoperative, run by Bozyaka Training and Research Hospital at 1 site in Turkey (Türkiye).

Unknown status

Status not confirmed. The sponsor has not verified this record for over two years, so it may be out of date.

Official record
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Trial summary

Femoral and adductor nerve blocks with ultrasonography(USG) guidance are used effectively and efficiently in post-operative pain management in lower extremity surgical procedures. However, the superiority of these two blocks to each other is still controversial. Read more about this study

Who is it for?
Ages 18 to 90 years
What is being tested?
Ultrasound Guided Middle Adductor Canal Block, Ultrasound Guided Femoral Nerve Block. and Bupivacain
Could I receive a placebo?
No, everyone receives an active treatment
How many people
52 participants
Where
1 siteTurkey (Türkiye)
Study dates
16 Apr 2021to 16 Apr 2022
Phase
Phase 4
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 to 90 years
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • ASA1-2-3 patients who will undergo unilateral elective primary total knee prosthesis surgery with consent for the study
  • Patients whose operation has been successfully completed with spinal anesthesia

Who cannot join

  • Refusal of the patient to work
  • Patients under 18 years of age
  • Patients who have undergone an anesthesia technique other than spinal anesthesia for any reason (general anesthesia, sedoanelgesia, laryngeal mask application, etc.)
  • Those with known local anesthetic allergies
  • Body mass index> 35 patient groups
  • Skin infection at the injection site
Show all 12Show fewer
  • Coagulopathy and use of anticoagulant therapy
  • Uncontrolled diabetic patients
  • Uncooperative patient
  • Physiological and emotional lability
  • Prolonged surgical intervention
  • Patient with limitation of mobilization and movement before the operation, other than the operation reason

Trial locations and contacts

1 site in 1 country.

Turkey (Türkiye)1 site
  • İzmir Bozyaka Training and Research Hospital

    Izmir, 35170

    Zeki Tuncel Tekgül, Assoc. Prof., 05058554705, zekittekgul@yahoo.com

    Elif Göktaş, MD

Other trials in Turkey (Türkiye)

About this study

Official title: Comparison Of Femoral Block And Middle Adductor Canal Block In Patients With Knee Arthroplasty In Terms Of Postoperative Pain Control And Early Mobilization

Femoral and adductor nerve blocks with ultrasonography(USG) guidance are used effectively and efficiently in post-operative pain management in lower extremity surgical procedures. However, the superiority of these two blocks to each other is still controversial. In this prospective, randomized, double-blind study, patients who underwent elective unilateral knee arthroplasty under spinal anesthesia, will be performed postoperative femoral block or middle adductor canal block with the guidance of USG.Patients who underwent spinal anesthesia and needed sedoanalgesia and who had to switch to general anesthesia will be excluded from the study. The patients will be divided into two groups by simple randomization. Since a total of 52 patients should be included in the study as a result of the power analysis (G-power 3.1); It is planned to take approximately 26 patients for each group.The anesthesiologist, who follows the pain control and mobilization after the block, will not know which study group the patient is in. The blocks will be performed behind the cover while the patient is under spinal anesthesia (Thus, the point of application of the block will not be noticed). In this way, the patient and the anesthesiologist who follows the parameters after the block will be blind to patient's arm. In the first group, 0.25% 20 ml of local anesthetic and middle adductor canal block, in the second group 0.25% 20 ml of local anesthetic and femoral nerve block will be applied We will compare these two blocks in terms of early mobilization, postoperative pain control, motor, and sensory block.

Read the detailed description

All patients scheduled for total knee arthroplasty will be evaluated before the operation. Eligible patients will be informed about the study and "Numeric Rating Scale" for pain evaluation. Then, patients will be asked for informed consent. After approval from the local research ethics committee, first patient will be recruited for study and patient's group will be determined by dice roll. Patients who are scheduled for primary total knee arthroplasty under spinal anesthesia with a planned sensory block level between T4 and T7 dermatomes, will be recruited and assigned to a group.Femoral block or middle adductor canal block will be applied to the patients.

Group1 (Group 1 Middle Adductor Canal Block) patients will be administered middle adductor canal block with 20 ml 0.25% Bupivacaine by an experienced anesthesiologist.

Group2 (Femoral Nerve Block) patients will be administered femoral block with 20 ml 0.25% Bupivacaine by an experienced anesthesiologist.

The selected block will be applied with USG behind the curtain after the operation.Patients will be taken to the postoperative recovery unit.Patients will be followed-up in post-anesthesia care unit and in the ward for 48 hours. Post-operatively, patients will receive 1mg/kg Tramadol when Numeric Rating Scale(NRS) > 3.The duration of the sensory and motor block and the mobilization of the patients will be recorded and compared.

0,2,4,6,8,12,24 of the patient pain scores at hour and 6 months, presence of sensory block and motor block, pain score when the patient is mobilized will be recorded.In addition, operation time, complications related to block, mobilization time, discharge day, and opioid need will be recorded.It will be recorded at what time the first opioid dose was administered after the block.

Being tested
Ultrasound Guided Middle Adductor Canal Block, Ultrasound Guided Femoral Nerve Block., Bupivacain, Spinal Anesthesia
Keywords
femoral nerve block, adductor block, knee arthroplasty
Medical subject headings
Pain, Postoperative, Agnosia

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Ultrasound Guided Middle Adductor Canal BlockProcedure or surgery

    Also called Regional Anesthesia

    Middle adductor canal block will be applied post-operatively with guidance of USG.

    Drug:Bupivacaine 0.25% Injectable Solution

  • Ultrasound Guided Femoral Nerve Block.Procedure or surgery

    Also called Regional Anesthesia

    Femoral nerve block will be applied post-operatively with guidance of USG. Drug:Bupivacaine 0.25% Injectable Solution

  • BupivacainDrug

    Also called Marcain

    10 ml %0,5 Bupivacaine will be diluted with 10 ml saline solution. Bupivacaine 0.25% Injectable Solution

  • Spinal AnesthesiaProcedure or surgery

    Patients will be placed in the lateral decubitus position.Subarachnoid space will be entered through the most suitable intervertebral space.Bupivacaine 0.5% Heavy will be given in the appropriate dose.

Study groups in NCT04768764
Study groupRoleWhat they receive
Group 1 Middle Adductor Canal BlockActive comparatorUltrasound Guided Middle Adductor Canal Block: 20 ml Bupivacaine 0.25% Injectable Solution will be administered for middle adductor canal block. 10 ml %0,5 Bupivacaine will be diluted with 10 ml saline solution.
Receives: Procedure: Ultrasound Guided Middle Adductor Canal Block; Drug: Bupivacain; Procedure: Spinal Anesthesia
Group 2 Femoral Nerve Block.Active comparatorUltrasound Guided Femoral Nerve Block: 20 ml Bupivacaine 0.25% Injectable Solution will be administered for femoral nerve block. 10 ml %0,5 Bupivacaine will be diluted with 10 ml saline solution.
Receives: Procedure: Ultrasound Guided Femoral Nerve Block.; Drug: Bupivacain; Procedure: Spinal Anesthesia

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Post-operative pain assessed by Numeric Rating Scale(NRS)

    Pain scores will be recorded as reported by the patient according to NRS

    Measured: At 0th hour postoperatively

  2. Post-operative pain assessed by Numeric Rating Scale(NRS)

    Pain scores will be recorded as reported by the patient while knee flexion according to NRS

    Measured: At 0th hour postoperatively

  3. Post-operative pain assessed by Numeric Rating Scale(NRS)

    Pain scores will be recorded as reported by the patient according to NRS

    Measured: At 2nd hour postoperatively

  4. Post-operative pain assessed by Numeric Rating Scale(NRS)

    Pain scores will be recorded as reported by the patient while knee flexion according to NRS

    Measured: At 2nd hour postoperatively

  5. Post-operative pain assessed by Numeric Rating Scale(NRS)

    Pain scores will be recorded as reported by the patient according to NRS

    Measured: At 4th hour postoperatively

  6. Post-operative pain assessed by Numeric Rating Scale(NRS)

    Pain scores will be recorded as reported by the patient while knee flexion according to NRS

    Measured: At 4th hour postoperatively

  7. Post-operative pain assessed by Numeric Rating Scale(NRS)

    Pain scores will be recorded as reported by the patient according to NRS

    Measured: At 6th hour postoperatively

  8. Post-operative pain assessed by Numeric Rating Scale(NRS)

    Pain scores will be recorded as reported by the patient while knee flexion according to NRS

    Measured: At 6th hour postoperatively

  9. Post-operative pain assessed by Numeric Rating Scale(NRS)

    Pain scores will be recorded as reported by the patient according to NRS

    Measured: At 8th hour postoperatively

  10. Post-operative pain assessed by Numeric Rating Scale(NRS)

    Pain scores will be recorded as reported by the patient while knee flexion according to NRS

    Measured: At 8th hour postoperatively

  11. Post-operative pain assessed by Numeric Rating Scale(NRS)

    Pain scores will be recorded as reported by the patient according to NRS

    Measured: At 12th hour postoperatively

  12. Post-operative pain assessed by Numeric Rating Scale(NRS)

    Pain scores will be recorded as reported by the patient while knee flexion according to NRS

    Measured: At 12th hour postoperatively

  13. Post-operative pain assessed by Numeric Rating Scale(NRS)

    Pain scores will be recorded as reported by the patient according to NRS

    Measured: At 24th hour postoperatively

  14. Post-operative pain assessed by Numeric Rating Scale(NRS)

    Pain scores will be recorded as reported by the patient while knee flexion according to NRS

    Measured: At 24th hour postoperatively

  15. Post-operative pain assessed by Numeric Rating Scale(NRS)

    Pain scores will be recorded as reported by the patient according to NRS

    Measured: At 6 months postoperatively

  16. Post-operative pain assessed by Numeric Rating Scale(NRS)

    Pain scores will be recorded as reported by the patient while knee flexion according to NRS

    Measured: At 6 months postoperatively

  17. Ambulation time

    First time a patients can walk around independently

    Measured: 48 hours postoperatively

  18. NRS at Ambulation

    NRS when first time a patients can walk around independently

    Measured: 48 hours postoperatively

Secondary outcomes (3)
  1. Time of First Rescue Opioid

    When patient's pain score(NRS) is 3 or more.

    Measured: 48 hours postoperatively

  2. Time of Return of Sensory Block

    Examined with Prick Test

    Measured: 24 hours postoperatively

  3. Time of Return of Motor Block

    Examined with Examined with Holmenn Skalası

    Measured: 24 hours postoperatively

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted24 Feb 2021
  2. Study start16 Apr 2021 (estimated)
  3. Primary completion16 Oct 2021 (estimated)
  4. Study completion16 Apr 2022 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase 4
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Model description
There are two groups: the first group is adductor block and the second group is femoral block.
Masking
Double blind
Who is masked
Participant, Care provider
Enrolment
52 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT04768764
Sponsor's protocol ID
elifgoktas
Status last verified
Feb 2021
First submitted
22 Feb 2021
Last updated
24 Feb 2021
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No

Questions about this trial

What is this clinical trial studying?

A Phase 4 study testing Ultrasound Guided Middle Adductor Canal Block, Ultrasound Guided Femoral Nerve Block. and Bupivacain in people with Arthroplasty, Replacement, Knee and Pain, Postoperative, run by Bozyaka Training and Research Hospital at 1 site in Turkey (Türkiye).

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 2 inclusion and 12 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: status not confirmed, as of the sponsor's last update on 24 Feb 2021. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in Turkey (Türkiye). Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

What does this phase mean?

Phase 4 studies take place after a treatment is approved, to learn more about its long-term benefits and risks in everyday use.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

Results are not available in the source record.

How can a doctor refer a patient or contact the research team?

Contact Elif Göktaş (05062073485, e.goktas44@hotmail.com), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Post-operative pain assessed by Numeric Rating Scale(NRS) (time frame: At 0th hour postoperatively). The study lists 18 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 24 Feb 2021.

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