Suprainguinal Fascia Iliaca Block vs. Adductor Canal Block for Analgesia After Total Knee Arthroplasty

N/ANot Yet RecruitingNCT07739108

Bursa Yuksek Ihtisas Training and Research Hospital60 enrolled

Overview

This study evaluates the analgesic efficacy and motor-sparing properties of ultrasound-guided Suprainguinal Fascia Iliaca Block (S-FIB) compared with Adductor Canal Block (ACB) in patients undergoing primary total knee arthroplasty (TKA). The main hypothesis is that ACB better preserves quadriceps muscle strength, allowing earlier functional mobilization, while providing comparable (non-inferior) analgesia to S-FIB.

Total knee arthroplasty is associated with severe postoperative pain requiring effective multimodal analgesia, and regional nerve blocks are integral to Fast-Track / ERAS (Enhanced Recovery After Surgery ) protocols. The Suprainguinal Fascia Iliaca Block (S-FIB) targets the anterior branches of the lumbar plexus (femoral, lateral femoral cutaneous, and obturator nerves) from a single high-volume injection, but proximal femoral spread can produce quadriceps motor weakness. The Adductor Canal Block (ACB) predominantly blocks the saphenous nerve, sparing motor function at the potential expense of less comprehensive analgesia.

Study Type

INTERVENTIONAL

Allocation

NON_RANDOMIZED

Purpose

TREATMENT

Masking

DOUBLE

Enrollment

Conditions

Arthroplasty Knee Osteoarthritis

Interventions

PCADRUG

All patients receive standardized spinal anesthesia and postoperative intravenous PCA tramadol within a standardized multimodal regimen.

Eligibility

Sex: ALLMin age: 45 YearsMax age: 100 Years

Medical Language ↔ Plain English

Inclusion Criteria: * ASA Physical Status I, II, or III * Scheduled for elective unilateral primary total knee arthroplasty * Able to understand and operate the PCA device * Written informed consent provided Exclusion Criteria: * Pre-existing lower-extremity neurological deficit or motor weakness (e.g., severe diabetic neuropathy) * Chronic opioid use (\>30 mg oral morphine equivalents/day for \>3 months) * Infection at the block site or systemic sepsis * Coagulopathy or bleeding diathesis * Allergy to local anesthetics or study medications * Revision TKA or bilateral knee procedures * Cognitive impairment or inability to perform mobility/pain assessments

Outcomes

Primary Outcomes

Postoperative Pain Intensity (NRS)

Numerical Rating Scale (0-10) at rest and during active knee flexion (30°). Time Frame: Postoperative hours 2, 6, 12, 24, and 48.

Time frame: Postoperative hours 24 hour

Secondary Outcomes

Quadriceps Muscle Strength

Active Straight Leg Raise (SLR) Angle Maximum hip flexion angle (degrees, 0-90°) achieved during an active straight leg raise in the supine position, measured with a digital clinometer/goniometer.

Time frame: Postoperative hours 6 and 12.

Cumulative Opioid Consumption

Total IV tramadol delivered via PCA (patient controlled analgesia).

Time frame: 24 and 48 hours postoperatively.

Time to First Mobilization

Hours from end of surgery to first assisted/unassisted ambulation

Time frame: Up to 48 hours postoperatively.

Quality of Recovery (QoR-15)

Validated 15-item questionnaire (0-150; higher = better recovery).

Time frame: Baseline (preoperative) and 24 hours postoperatively.

Central Contacts

Korgün Ökmen

CONTACT

+905057081021 korgunokmen@gmail.com

Data from ClinicalTrials.gov

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