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Completed

NCT Number: NCT05613101

ESPB and ACB in Knee Arthroplasty

Total knee arthroplasty surgery is preferred in the treatment of osteoarthritis and causes severe postoperative pain. In this study, we aimed to investigate the effects of lumbar erector spina plan block and adductor canal block on postoperative pain and quadriceps muscle strength in patients who underwent total knee arthroplasty with spinal anesthesia.

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Key information

Conditions

Post Operative Pain Neurologic Manifestations Pain Pain, Postoperative Pathologic Processes Pathological Conditions, Signs and Symptoms Postoperative Complications Signs and Symptoms

Age range

18 year–75 year

Sex eligibility

All sexes

Study type

Interventional

Phase

Not applicable

Primary location

Istanbul Medeniyet University Goztepe Suleyman Yalcın City Hospital

Istanbul, Turkey (Türkiye)

About this study

In a prospective, randomized study; Medeniyet University Faculty of Medicine Göztepe Prof. Dr. Forty patients who underwent total knee arthroplasty surgery at Süleyman Yalçın City Hospital were divided into two groups. After the surgery was completed, erector spina plane block was applied to Group E (n=20) patients with 20 ml of 0.25% bupivacaine from the operated side L3-L4 level, while in Group A (n=20) patients, in the area where the sartorius muscle crosses the adductor magnus muscle, it was lateral to the superficial femoral artery. Adductor canal block was applied to the adductor canal with 20 ml of 0.5% bupivacaine. All patients were administered 1 gr paracetamol and 75 mg diclofenac sodium when their pain started in the orthopedic ward. Numerical pain score and quadriceps muscle strength were evaluated during the 48-hour follow-up of the patients. When the pain score was 4 and above, 50 mg pethidine hydrochloride was administered.

Who can participate

Healthy volunteers accepted: No

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

Inclusion criteria

  • patients who underwent total knee arthroplasty surgery
  • ASA I-III patients

Exclusion criteria

  • Patients with coagulopathy
  • Patients history with local anesthetic allergy or toxicity
  • Patients with long hospital stay
  • Patients with advanced organ failure
  • Mental retarded patients
  • Presence of infection at the injection site

Treatment and study plan

Erector Spinae Plane Block

Procedure

After the necessary asepsis and antisepsis procedures, the linear ultrasound probe was placed parasagittally 2-3 cm lateral to the spinous process at the L3 or L4 level and the transverse process was visualized. The peripheral block needle (85 mm B Braun Stimuplex A) was advanced in plane up to the transverse process and 10 ml 0.5% bupivacaine hydrochloride 10 ml 0.9% isotonic NaCl mixture was applied on the erector spina muscle.

Adductor canal block

Procedure

After the necessary asepsis and antisepsis procedures, the linear ultrasound probe was placed in the middle between the medial condyle and the SIAS, and the superficial femoral artery (FSA) was visualized under the sartorius muscle. By following the FSA distally, the point where the sartorius muscle crosses the adductor magnus muscle, which is the beginning of the adductor canal, was found and the saphenous nerve was visualized hyperechoic in the anterolateral aspect of the FSA. 20 cc 0.5% bupivacaine hydrochloride was applied

Primary outcomes

  1. Postoperative pain 30 minute

    Time frame: 30. min.

    Visual anolog score (1-10)

  2. Postoperative pain 1. hour

    Time frame: 1. hour

    Visual anolog score (1-10)

  3. Postoperative pain 2. hour

    Time frame: 2. hour

    Visual anolog score (1-10)

  4. Postoperative pain 6. hour

    Time frame: 6. hour

    Visual anolog score (1-10)

  5. Postoperative pain 12. hour

    Time frame: 12. hour

    Visual anolog score (1-10)

  6. Postoperative pain 24. hour

    Time frame: 24. hour

    Visual anolog score (1-10)

  7. Postoperative pain 36. hour

    Time frame: 36. hour

    Visual anolog score (1-10)

  8. Postoperative pain 48. hour

    Time frame: 48. hour

    Visual anolog score (1-10)

Secondary outcomes

  1. Opioid consuption 30. min.

    Time frame: 30. min.

    Petidine (mg)

  2. Opioid consuption 1. hour

    Time frame: 1. hour

    Petidine (mg)

  3. Opioid consuption 2. hour

    Time frame: 2. hour

    Petidine (mg)

  4. Opioid consuption 6. hour

    Time frame: 6. hour

    Petidine (mg)

  5. Opioid consuption 12. hour

    Time frame: 12. hour

    Petidine (mg)

  6. Opioid consuption 24. hour

    Time frame: 24. hour

    Petidine (mg)

  7. Opioid consuption 36. hour

    Time frame: 36. hour

    Petidine (mg)

  8. Opioid consuption 48. hour

    Time frame: 48. hour

    Petidine (mg)

Sponsors and collaborators

Lead sponsor

Istanbul Medeniyet University

Other

Registry information

Official study title

Comparison of the Effects of Ultrasound-Guided Erector Spinae Plane Block and Adductor Canal Block on Postoperative Pain, Opioid Consumption and Quadriceps Muscle Strength in Total Knee Arthroplasty Surgery

Important dates

Study start
2021
Primary completion
2022
Study completion
2022
First posted
Nov 14, 2022
Registry last updated
Nov 14, 2022

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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