Adductor Canal Block (ACB) Versus ACB /Saphenous Block in Patients Undergoing Anterior Cruciate Ligament Repair
- Conditions
- Postoperative Pain
- Interventions
- Procedure: Ultrasound Guided Adductor Canal BlockProcedure: General anesthesiaProcedure: Ultrasound Guided Saphenous Nerve Block
- Registration Number
- NCT04443634
- Lead Sponsor
- Cairo University
- Brief Summary
Knee surgeries are associated with severe postoperative pain. Blocking the femoral nerve (or saphenous nerve) in the adductor canal is increasingly used for knee analgesia. It carries potential benefits that encourage anesthesiologists to do it. It has a motor sparing property. Injection of local anesthetics in this lengthy canal that contains a variable amount of connective or fibrous tissue might lead to a patchy distribution of local anesthetics. Thus, the possibility of incomplete block of the saphenous nerve (most important nerve in knee innervations) cannot be excluded.
- Detailed Description
Aim of the study is to compare the efficacy of the adductor canal block to the combined adductor canal block and saphenous nerve block at the distal third of thigh in the intermuscular plane between Vastus Medialis and Sartorius muscles in pain relief following knee arthroscopic anterior cruciate ligament repair.
After written informed consent, patients will be randomized in three groups:
Group (Adductor 20): Ultrasound guided adductor canal block will be performed with injection of 20 ml bupivcaine 0.5%.
Group (Adductor 30) Ultrasound guided adductor canal block will be performed with injection of 30 ml bupivacaine 0.5%. Group (Adductor/saphenous ): Ultrasound guided adductor canal block will be performed by injection of 20 ml bupivacaine 0.5%, combined with ultrasound guided saphenous
Recruitment & Eligibility
- Status
- UNKNOWN
- Sex
- All
- Target Recruitment
- 88
- Scheduled for knee orthopedic ( ACL repair)
- Physical status ASA I, II.
- Body mass index (BMI): > 20 kg/m2 and < 35 kg/m2.
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• Patients with known sensitivity or contraindication to drug used in the study (local anesthetics, opioids).
- History of psychological disorders and/or chronic pain.
- Contraindication to regional anesthesia e.g. local sepsis, pre- existing peripheral neuropathies and coagulopathy.
- Infection of the skin at the site of needle puncture area.
- Patient refusal.
- Severe respiratory or cardiac disorders.
- Advanced liver or kidney disease.
- Pregnancy.
- Patient with surgery duration more than two hours.
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Arm && Interventions
Group Intervention Description Adductor 20 Bupivacaine 20 ml Ultrasound guided adductor canal block will be performed with injection of 20 ml bupivacaine Adductor 20 Ultrasound Guided Adductor Canal Block Ultrasound guided adductor canal block will be performed with injection of 20 ml bupivacaine Adductor 20 General anesthesia Ultrasound guided adductor canal block will be performed with injection of 20 ml bupivacaine Adductor 30 Ultrasound Guided Adductor Canal Block Ultrasound guided adductor canal block will be performed with injection of 30ml bupivacaine Adductor 30 General anesthesia Ultrasound guided adductor canal block will be performed with injection of 30ml bupivacaine Adductor 30 Bupivacaine 30ml Ultrasound guided adductor canal block will be performed with injection of 30ml bupivacaine Adductor /Saphenous Ultrasound Guided Adductor Canal Block Ultrasound guided adductor canal block will be performed by injection of 20 ml bupivacaine , combined with ultrasound guided saphenous nerve block at the distal third of the thigh in the intermuscular plane between Vastus Medialis and Sartorius muscle with injection of 10ml bupivacaine 0.5%. Adductor /Saphenous Ultrasound Guided Saphenous Nerve Block Ultrasound guided adductor canal block will be performed by injection of 20 ml bupivacaine , combined with ultrasound guided saphenous nerve block at the distal third of the thigh in the intermuscular plane between Vastus Medialis and Sartorius muscle with injection of 10ml bupivacaine 0.5%. Adductor /Saphenous General anesthesia Ultrasound guided adductor canal block will be performed by injection of 20 ml bupivacaine , combined with ultrasound guided saphenous nerve block at the distal third of the thigh in the intermuscular plane between Vastus Medialis and Sartorius muscle with injection of 10ml bupivacaine 0.5%. Adductor /Saphenous Bupivacaine 20 ml Ultrasound guided adductor canal block will be performed by injection of 20 ml bupivacaine , combined with ultrasound guided saphenous nerve block at the distal third of the thigh in the intermuscular plane between Vastus Medialis and Sartorius muscle with injection of 10ml bupivacaine 0.5%. Adductor /Saphenous Bupivacaine 10ml Ultrasound guided adductor canal block will be performed by injection of 20 ml bupivacaine , combined with ultrasound guided saphenous nerve block at the distal third of the thigh in the intermuscular plane between Vastus Medialis and Sartorius muscle with injection of 10ml bupivacaine 0.5%.
- Primary Outcome Measures
Name Time Method The total dose of morphine consumption in the first 24 hours postoperatively. 24 hours postoperative The total amount of morphine consumption in the first 24 hours postoperatively.
- Secondary Outcome Measures
Name Time Method Failure rate of the block 24 hours • Failure rate of the block will be calculated, where the block will be considered a failed block if the patient requires more than two doses of rescue analgesia in the first hour postoperatively.
Block related complications 1 mounth o The incidence of vascular puncture, and presence or absence of saphenous nerve neuritis during the first month after surgery were also recorded
Total dose of intraoperative fentanyle adminstration 2 hours intraoperatively Numeric Pain Rating Scale 24 hours postoperative Numeric Pain Rating Scale, both at rest and during movement: 30 minutes,2, 4,6, 8, 12, 16, 20 and 24 hours postoperatively. It is labeled from zero to ten, with zero being an example of someone with no pain and ten being the worst pain possible.
Trial Locations
- Locations (1)
Anesthesia Department
🇪🇬Cairo, Egypt