Efficacy of Peripheral Nerve Blocks in Total Knee Arthroplasty
Investigation of the Effectiveness of Adductor Canal Block and Suprainguinal Fascia Iliaca Block in Patients Planned for Total Knee Arthroplasty
Tokat Gaziosmanpasa University
86 participants
Jun 8, 2025
INTERVENTIONAL
Conditions
Summary
In total knee arthroplasty, the effectiveness of some peripheral nerve blocks in postoperative pain control has been investigated, with conflicting results reported. The primary aim of this study is to evaluate the effects of the suprainguinal fascia iliaca plane block, which is routinely performed in our clinic for postoperative pain management, and the adductor canal block in patients undergoing total knee arthroplasty under spinal anesthesia. Patients scheduled for total knee arthroplasty under spinal anesthesia will be randomly assigned using computer-generated randomization into two groups: the adductor canal block group (Group A) and the suprainguinal fascia iliaca plane block group (Group S). The nerve blocks will be performed by a single investigator according to the assigned group. Postoperative follow-up assessments will be conducted and recorded by a different investigator who is blinded to which nerve block was performed.
Eligibility
Inclusion Criteria3
- Patients aged between 18 and 75 years
- Patients classified as ASA I, II, or III based on physical status
- Patients scheduled for total knee arthroplasty under spinal anesthesia
Exclusion Criteria5
- Patients with chronic pain conditions.
- Patients with a history of allergy to opioids or local anesthetics.
- Patients with psychiatric disorders that may impair cooperation.
- Patients with bleeding disorders or those using anticoagulant therapy.
- Patients unwilling to participate voluntarily in the study.
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Interventions
For postoperative pain management, a patient-controlled analgesia (PCA) pump will be routinely applied to the patient in our clinic. An infusion of an opioid (tramadol hydrochloride) at an appropriate dose will be administered via intravenous route through the pump, and the patient will be provided with detailed information about its use. Instead of continuous infusion, the device will deliver intermittent bolus doses when the patient's numeric rating scale (NRS) score is 4 or higher.
All patients will receive routine prophylactic analgesia with 1 gram of intravenous paracetamol every 6 hours (which may be skipped if the patient's pain score is 2 or below and they do not request pain relief).
If the pain persists despite the administered analgesics and the patient's pain score remains 4 or above, rescue analgesia with intramuscular diclofenac sodium, which is routinely used in our clinic, will be administered.
Locations(1)
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NCT07040709