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NCT Number: NCT07301476

Evaluation of Local Anesthetic Diffusion to the Sciatic Nerve During Adductor Canal Block

Adductor canal block is an effective analgesic technique for major knee surgery. However, the saphenous nerve block is not sufficient to explain this block's efficiency. It has been shown that adductor canal block can spread to the tibial and fibular nerves through the adductor hiatus. However, this diffusion's frequency has never been measured. The main objective of this study is to assess clinically the frequency of the spread of the adductor canal block to the fibular and tibial nerves.

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Key information

Conditions

Sciatic Nerve Adductor Canal Syndrome

Age range

18 year and older

Sex eligibility

All sexes

Study type

Observational

Primary location

Department of Anesthésia, CHU Raymond Poincaré - APHP

Boulogne-Billancourt, 92100, France

Location status: Recruiting

About this study

Adductor canal block is an effective analgesic technique for major knee surgery. The PROSPECT group recommends this block in first intention for locoregional anesthesia in total knee arthroplasty. It has been shown to not be inferior to femoral nerve block in this indication.

The adductor canal block targets the saphenous nerve and, through its spread in the adductor canal, the posterior branch of obturator nerve and the vastus medialis nerve. However, these nerves can't fully explain this block's efficiency.

It has been shown that local anesthetic can spread in the adductor canal to the tibial and fibular nerves through the adductor hiatus. However, this spread is inconstant, and no study has evaluated the frequency of this spread yet.

The main objective of this study is to assess the diffusion's frequency of adductor canal block to fibular and tibial nerves through clinical sensorimotor testing.

Who can participate

Healthy volunteers accepted: No

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

Inclusion criteria

  • patients over 18 years old scheduled for elective knee surgery under general anesthesia
  • in our center
  • receiving an adductor canal block

Exclusion criteria

  • patients cognitively impaired,
  • patients suffering from peripheral neuropathy at the lower limb,
  • patients receiving an IPACK block or surgical knee infiltration to complete the adductor canal block analgesia.
  • patients who refused to take part in this study
  • pregnant or breastfeeding patients
  • patients under guardianship
  • imprisoned patients,
  • patients without any medical insurance

Treatment and study plan

Primary outcomes

  1. Frequency of local anesthetic's spread to tibial and fibular nerve

    Time frame: at 4 hours

    The primary outcome is the frequency of local anesthetic's spread to tibial and fibular nerve during an adductor canal block, assessed by sensory and motor testing of these nerve territories.

    Sensorimotor testing will be performed at four hours with loco-regional anaesthesia.

Secondary outcomes

  1. Frequency of reduction of sensitivity to cold or touch or reduction in MRC score

    Time frame: at 1 hour and at 4 hours

    Frequency of reduction of sensitivity to cold or touch or reduction in MRC score in fibular and tibial nerves territories assessed at one and four hours after the adductor canal block has been performed, as well as reduction of sensitivity to cold or touch in saphenous nerve territory assessed at one and four hours after nerve block.

  2. Spread of the local anesthetic in the popliteal fossa

    Time frame: at baseline

    Qualitative assessment of local anaesthetic spread in the popliteal fossa on ultrasound recording (spread or no spread).

  3. Evaluation of the positive and negative predictive value

    Time frame: at baseline and 1 hour, 4 hours

    Evaluation of the positive and negative predictive value, sensitivity and specificity, and positive and negative likelihood ratio of ultrasound-visualised diffusion to the tibial and fibular nerves as a predictive test for clinical impairment of the sensitivity and motor function of these nerves at 1 hour or 4 hours

  4. Clinical alteration assessement

    Time frame: at Baseline and at 1 hour and 4 hours

    Clinical alteration of sensibility and motricity will be assessed before the adductor canal block is performed and then at H1 and H4. The ultrasound scan of the popliteal fossa will be performed at the same time as the local anaesthetic is administered.

Study contacts

Contact information is provided by the study sponsor or research team.

Romuald Henry, MD

CONTACT

[email protected]

+ 33 06 72 83 17 51

Sponsors and collaborators

Lead sponsor

Assistance Publique - Hôpitaux de Paris

Other

Registry information

Official study title

Evaluation of Local Anesthetic Diffusion to the Sciatic Nerve During Adductor Canal Block: an Observational Study

Acronym: DiffuCAdd

Important dates

Study start
2025
Primary completion
2027
Study completion
2027
First posted
Dec 24, 2025
Registry last updated
Dec 24, 2025

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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