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Completed

NCT Number: NCT07517159

Adductor Canal Block Combined With Local Infiltration Analgesia vs Local Infiltration Analgesia Alone for Postoperative Pain in Total Knee Arthroplasty

Total knee arthroplasty (TKA) is commonly associated with significant postoperative pain, which may impair early mobilization and functional recovery. Multimodal analgesia techniques are widely used to improve postoperative pain control while minimizing opioid consumption. Local infiltration analgesia (LIA) is a commonly used method; however, its effectiveness may be limited when used alone. The adductor canal block (ACB) provides effective analgesia while preserving quadriceps muscle strength.

This prospective randomized controlled study aims to compare the effectiveness of adductor canal block combined with local infiltration analgesia versus local infiltration analgesia alone on postoperative pain scores in patients undergoing total knee arthroplasty. The primary outcome is postoperative pain assessed using the NRS at multiple time points within the first 48 hours. Secondary outcomes include opioid consumption, functional recovery parameters and hemodynamic parameters.

The results of this study are expected to contribute to optimizing postoperative analgesia strategies in total knee arthroplasty.

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Key information

Conditions

Osteoarthritis, Knee Arthritis Joint Diseases Musculoskeletal Diseases Neurologic Manifestations Osteoarthritis Pain Pain, Postoperative Pathologic Processes Pathological Conditions, Signs and Symptoms Postoperative Complications Rheumatic Diseases Signs and Symptoms

Age range

18 year and older

Sex eligibility

All sexes

Study type

Interventional

Phase

Not applicable

Primary location

Ankara University Faculty of Medicine, Ibni Sina Hospital

Ankara, 06100, Turkey (Türkiye)

About this study

Total knee arthroplasty (TKA) is frequently associated with moderate to severe postoperative pain, which can negatively affect early mobilization, rehabilitation, and patient satisfaction. Effective pain management strategies are essential for enhanced recovery protocols. Multimodal analgesia has become the standard approach, combining different techniques to improve analgesic efficacy while reducing opioid-related side effects.

Local infiltration analgesia (LIA) is widely used as part of multimodal analgesia; however, it may not always provide sufficient analgesia when used alone. The adductor canal block (ACB) has gained popularity due to its ability to provide sensory blockade of the saphenous nerve while preserving quadriceps muscle strength, thus facilitating early mobilization.

This prospective randomized controlled trial was conducted to evaluate the effect of combining ACB with LIA compared to LIA alone in patients undergoing total knee arthroplasty. Patients were randomly assigned into two groups: one group received ACB combined with LIA, while the control group received LIA alone.

Postoperative pain was assessed using the Visual Analog Scale (VAS) at 2, 6, 12, 24 and 48 hours postoperatively. Secondary outcomes included total opioid consumption and functional recovery parameters. Demographic data, operative variables, and perioperative characteristics were also recorded and analyzed.

The findings of this study aim to provide evidence regarding the efficacy of combining regional anesthesia techniques with local infiltration analgesia in improving postoperative pain control following total knee arthroplasty.

Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

  • Patients aged 18 years and older
  • Patients scheduled for elective total knee arthroplasty
  • American Society of Anesthesiologists (ASA) physical status I-III
  • Patients who provided written informed consent

Exclusion criteria

  • Known allergy to local anesthetics
  • Coagulation disorders or anticoagulant therapy contraindicating regional anesthesia
  • Infection at the injection site
  • Severe hepatic or renal dysfunction
  • Neurological disorders affecting lower extremities
  • Cognitive impairment preventing pain assessment
  • Refusal to participate
  • Body mass index (BMI) greater than 30 kg/m²

Treatment and study plan

Adductor canal block

Procedure

Ultrasound-guided adductor canal block was performed using local anesthetic to provide postoperative analgesia.

Local Infiltration Analgesia

Procedure

Local infiltration analgesia was administered intraoperatively using local anesthetic agents around the surgical site.

Primary outcomes

  1. Postoperative pain at rest (Numerating Rating Scale, NRS)

    Time frame: 2,6,12,24,48

    Postoperative pain was assessed using the NRS at rest at predefined time points. Postoperative pain was assessed using the Numeric Rating Scale (NRS), ranging from 0 to 10, where 0 indicates no pain and 10 indicates the worst imaginable pain. Pain scores were recorded at rest at predefined time points.

Secondary outcomes

  1. Opioid Consumption

    Time frame: 0-48 hours postoperatively

    Total opioid consumption within the first 48 hours postoperatively.

  2. Knee flexion range of motion (degrees) measured with a goniometer

    Time frame: 24 and 48 hours postoperatively

    Functional recovery will be assessed by measuring knee flexion range of motion (degrees) using a standard goniometer at predefined postoperative time points.

  3. Heart rate (beats per minute)

    Time frame: Baseline (preoperative) and every 15 minutes from induction of anesthesia to extubation

    Heart rate (beats per minute) will be recorded at baseline and at 15-minute intervals from induction of anesthesia to extubation.

  4. Mean arterial pressure (mmHg)

    Time frame: Baseline (before induction of anesthesia) and every 15 minutes from induction of anesthesia to extubation

    Mean arterial pressure (mmHg) will be recorded at baseline (preoperative) and at 15-minute intervals during the intraoperative period.

Sponsors and collaborators

Lead sponsor

Ankara University

Other

Registry information

Official study title

Comparison of the Effect of Adductor Canal Block Combined With Local Infiltration Analgesia Versus Local Infiltration Analgesia Alone on Postoperative Pain Scores in Total Knee Arthroplasty

Acronym: ADB_01

Important dates

Study start
2025
Primary completion
2025
Study completion
2025
First posted
Apr 8, 2026
Registry last updated
Apr 8, 2026

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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