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Completed

NCT Number: NCT07320833

Ultrasound-Guided PASC Block vs Femoral-Sciatic Nerve Block for Postoperative Analgesia After Total Knee Arthroplasty

This randomized, double-blind comparative study evaluates postoperative analgesic efficacy and motor effects of ultrasound-guided para-sartorial compartments (PASC) block versus ultrasound-guided combined femoral-sciatic nerve block in patients undergoing total knee arthroplasty. The primary endpoint is total nalbuphine rescue analgesia consumption in the first 24 postoperative hours. Secondary endpoints include pain scores (NRS), motor function using a modified Bromage scale, block performance characteristics, and complications.

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Key information

Conditions

Knee Osteoarthritis Arthritis Bites and Stings Chemically-Induced Disorders Joint Diseases Musculoskeletal Diseases Neurologic Manifestations Osteoarthritis Osteoarthritis, Knee Pain Pain, Postoperative Pathologic Processes Pathological Conditions, Signs and Symptoms Poisoning Postoperative Complications Postoperative Pain Rheumatic Diseases Signs and Symptoms Total Knee Arthroplasty Wounds and Injuries

Age range

60 year–70 year

Sex eligibility

All sexes

Study type

Interventional

Phase

Not applicable

Primary location

Ain Shams University Hospitals

Cairo, Cairo Governorate, 11511, Egypt

Who can participate

Healthy volunteers accepted: No

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

Inclusion criteria

  • Age 60 to 70 years
  • Scheduled for elective total knee arthroplasty under general anesthesia
  • American Society of Anesthesiologists physical status class I or II
  • Provided written informed consent

Exclusion criteria

  • American Society of Anesthesiologists physical status class III or IV
  • Pre-existing neurological abnormality of the lower extremity
  • Infection near the planned block site
  • History of psychiatric illness
  • History of drug abuse
  • Known allergy to local anesthetics or any study medications (bupivacaine, acetaminophen, ketorolac, nalbuphine)

Treatment and study plan

Ultrasound-Guided Femoral Nerve Block plus Sciatic Nerve Block

Procedure

Single-shot ultrasound-guided femoral nerve block (15 milliliters of 0.25% bupivacaine) plus single-shot ultrasound-guided popliteal sciatic nerve block (15 milliliters of 0.25% bupivacaine), performed after induction of general anesthesia using sterile technique.

Ultrasound-Guided Para-sartorial Compartments Block

Procedure

Single-shot ultrasound-guided para-sartorial compartments block performed after induction of general anesthesia using a single needle entry point and three injections of 0.25% bupivacaine: 10 milliliters in the femoral triangle with periarterial and subsartorial spread, 10 milliliters in the subsartorial plane at the apex of the femoral triangle, and 10 milliliters in the suprasartorial compartment at the level of the intermediate femoral cutaneous nerve (total 30 milliliters).

Primary outcomes

  1. Total Rescue Analgesia Requirement (Nalbuphine)

    Time frame: First 24 hours after surgery.

    Total dose of intravenous nalbuphine (in milligrams) administered as rescue analgesia when the Numeric Rating Scale pain score is 3 or higher, with a maximum daily dose of 20 milligrams.

Secondary outcomes

  1. Postoperative Pain Intensity (Numeric Rating Scale)

    Time frame: 30 minutes after admission to the post-anesthesia care unit, and 3 hours, 6 hours, 12 hours, and 24 hours after surgery.

    Pain intensity measured using the Numeric Rating Scale (0 = no pain, 10 = worst possible pain).

  2. Motor Block Assessment (Modified Bromage Scale)

    Time frame: 2 hours, 4 hours, 6 hours, 12 hours, 18 hours, and 24 hours after surgery.

    Motor function assessed using the modified Bromage scale: 1 = complete block (unable to move knee or feet), 2 = almost complete (able to move feet only), 3 = partial (just able to move knees), 4 = none (full flexion of knees and feet).

  3. Block Performance Time

    Time frame: During block performance immediately after induction of general anesthesia.

    Time from ultrasound scanning start to completion of local anesthetic injection (in minutes).

  4. Block Duration

    Time frame: Up to 24 hours after surgery.

    Duration of sensory and motor effects of the nerve block as assessed clinically (in hours).

  5. Postoperative Nausea

    Time frame: First 24 hours after surgery.

    Presence of postoperative nausea during the first postoperative day.

  6. Postoperative Vomiting

    Time frame: First 24 hours after surgery.

    Presence of postoperative vomiting during the first postoperative day.

  7. Sedation (Richmond Agitation-Sedation Scale)

    Time frame: First 24 hours after surgery.

    Richmond Agitation-Sedation Scale score ranging from +4 (combative) to -5 (unarousable); 0 indicates alert and calm.

Sponsors and collaborators

Lead sponsor

Ain Shams University

Other

Registry information

Official study title

Postoperative Analgesic Efficacy of Ultrasound Guided Para-sartorial Compartments (PASC) Block Versus Combined Femoral-Sciatic Nerve Block in Patients Undergoing Total Knee Arthroplasty: A Double-Blind Randomized Comparative Study

Important dates

Study start
2023
Primary completion
2024
Study completion
2024
First posted
Jan 6, 2026
Registry last updated
Jan 6, 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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