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Completed

NCT Number: NCT07115771

Comparison of Ultrasound-Guided Lumbar ESPB and ACB for Knee Arthroplasty

Total knee arthroplasty (TKA) is a surgical procedure frequently associated with moderate-to-severe postoperative pain. While Adductor Canal Block (ACB) has demonstrated analgesic efficacy in TKA, the Erector Spinae Plane Block (ESPB) is also being utilized as part of multimodal analgesia for postoperative pain management in lower extremity surgeries. Currently, there is a gap in the literature as no studies have directly compared the efficacy of ACB and ESPB for pain management following TKA. The primary objective of this study is to compare the efficacy of these two analgesic methods in the context of postoperative analgesia management after total knee arthroplasty.

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Key information

Conditions

Total Knee Anthroplasty

Age range

18 year–65 year

Sex eligibility

All sexes

Study type

Interventional

Phase

Not applicable

Primary location

Bursa City Hospital

Bursa, Nilüfer, 16110, Turkey (Türkiye)

About this study

In our clinic, various regional blocks are applied for analgesia or anesthesia purposes in many surgeries, including knee surgery. For knee surgery, adductor canal block, lumbar epidural analgesia, genicular block, erector spinae plane block, and iPACK block can be used. In our clinic, erector spinae plane block and adductor canal block are routinely applied to knee surgery patients. In our study, we aimed to contribute to the literature by comparing patient satisfaction surveys and pain follow-up in patients undergoing knee arthroplasty who received adductor canal block versus lumbosacral erector spinae plane block, both applied with PROSPECT protocols for postoperative analgesia.

Who can participate

Healthy volunteers accepted: No

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

Inclusion criteria

Patients aged 18-65 years Patients scheduled for elective total knee arthroplasty under spinal anesthesia ASA physical status I-II Written informed consent Exclusion Criteria Refusal to participate Coagulopathy or inability to discontinue anticoagulant therapy appropriately Allergy or toxicity history to local anesthetics or opioids Infection at the injection site Severe cardiac, hepatic, or renal failure Diabetes mellitus-related neuropathy Peripheral neuropathy or motor-sensory deficit in the relevant extremity Psychiatric disease, cognitive impairment, or inability to cooperate Substance or alcohol abuse Pregnancy, suspected pregnancy, or breastfeeding Body mass index >40 kg/m² Failed spinal anesthesia or need for additional intraoperative anesthesia/analgesia

Treatment and study plan

Postoperative analgesia management

Other

After determining the L5-S1 level with ultrasound guidance, an 80 mm block needle (Stimuplex Ultra®, Braun, Melsungen, Germany) will be advanced in a cranio-caudal direction. Following hydrodissection, 30 ml of 0.25% bupivacaine local anesthetic solution containing 7.5 mcg of epinephrine (1:200,000) will be administered.

Primary outcomes

  1. opioid consumption

    Time frame: 0-48 hours postoperatively

    Tramadol will be prepared as 5mg/ml and patient-controlled analgesia will be administered without basal infusion, with a locking time of 20 minutes and a bolus dose of 10mg.

Secondary outcomes

  1. Postoperative pain scores (Numerical rating scale) (0-meaning "no pain" to 10-meaning "worst pain imaginable")

    Time frame: The NRS scores of the patients will be evaluated at the postoperative 0, 2, 4, 8, 16, 24 and 48 hours.

    Postoperative 48 hours period. Patients' pain scores will be questioned at 0, 2, 4, 8, 16, 24 and 48 hours.

  2. Global recovery scoring system (patient satisfaction scale)

    Time frame: The quality of recovery will be evaluated out of a total of 150 points according to the QoR-15 test to be applied at the portoperative 48th hour.

    Researchers will use the Turkish version of the Quality Improvement Survey/QoR-15. PART A: Participants will be asked by researchers how they felt in the last 24 hours.(0 to 10, where: 0 = none of the time [poor] and 10 = all of the time [excellent]) 1. Able to breathe easily 2. Been able to enjoy food 3. Feeling rested 4. Have had a good sleep 5. Able to look after personal toilet and hygiene unaided 6. Able to communicate with 7. Getting support from hospital doctors and nurses 8. Able to return to work or usual home activities 9. Feeling comfortable and in control 10. Having a feeling of general well-being PART B Participants will be asked by the researchers whether they have experienced any of the following in the last 24 hours. (10 to 0, where: 10 = none of the time [excellent] and 0 = all of the time [poor]) 11. Moderate pain 12. Severe pain 13. Nausea or vomiting 14. Feeling worried or anxious 15. Feeling sad or depressed

  3. Determine the time to first postoperative mobilization (The Timed Up and Go - TUG test):

    Time frame: The Timed Up and Go (TUG) test will be performed at the 20th minute after the preoperative block.

    Place a chair in a location where walking can be observed. The area should be free of obstacles and interruptions. Measure a distance of 3 meters and draw a line on the floor at this distance. Use colored tape if available (to be clearly visible from the floor). Seat the patient in a chair, with access to their usual walking aid if applicable. Ask the patient to "start" and begin the timer. The patient stands up, walks past the 3-meter mark, turns, then walks back to the chair and sits down again. Record the time taken to complete the entire maneuver.

Sponsors and collaborators

Lead sponsor

Bursa City Hospital

Other Gov

Collaborators

  • Ulusoy, Emre, M.D.

Registry information

Official study title

Comparison of Ultrasound-Guided Lumbar Erector Spinae Plane Block and Adductor Canal Block on Postoperative Analgesia Management in Patients Undergoing Knee Arthroplasty

Important dates

Study start
2025
Primary completion
2026
Study completion
2026
First posted
Aug 11, 2025
Registry last updated
May 11, 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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