Geniculate Nerve Block Versus Adductor Canal Block for ACL Reconstruction Surgery

Not Applicable

Recruiting

• Conditions: ACL Tear; Pain, Postoperative
• Interventions: Procedure: Adductor canal block

• Registration Number: NCT06486246
• Lead Sponsor: Hospital Clinic of Barcelona

Brief Summary

Anterior cruciate ligament repair (ACL) surgery presents moderate to severe pain during the inmediate postoperative period and the first days after surgery. In addition, due to the interest of surgeons and patients for early reinstatement, the use of blockages that decrease the strength of the quadriceps is avoided. Therefore, in recent years, the adductor canal block (ACB) has been used for postoperative analgesia with variable results.

Genicular nerve block (GNB) has been used for pain management in patients with knee osteoarthritis and recently in knee arthroplasty surgery with results similar to the local anesthetic infiltration techniques by the surgeon (LIA). Considering their good results in these patients in addition to being a 100% sensitive block without risk of motor involvement.

The investigators proposed this experimental study to evaluate tha analgesic efficacy of the genicular nerve block (GNB) compared with the adductor canal block (ACB) for the Anterior cruciate ligament (ACL) repair surgery.

Detailed Description

Participants scheduled to undergo anterior cruciate ligament reconstruction under general anaesthesia will be allocated to two groups: Adductor canal block or Genicular nerve block- The adductor canal block will be performed by the anaesthesiologist under ultrasound guidance prior the surgery, after inducction , using 20 mLs Ropivacaine 0.2%. The genicular nerve block will be performed by the anaesthesiologist under ultrasound guidance prior the surgery, after inducction , using 20 mLs Ropivacaine 0.2% in total.

Postoperative analgesia will include analgesia (Dexketoprofen 75 mg during first 24 hours), acetomiophen 1 gr every 8 hours and tramadol for rescue pain.

Study Timeline

• Study First Submitted: 2024-05-02
• Status Verified: 2024-06
• Study Start: 2024-06-26
• Study First Submitted QC: 2024-06-26
• Last Update Submitted: 2024-06-26
• Study First Posted: 2024-07-03
• Last Update Posted: 2024-07-03
• Primary Completion: 2024-09-30
• Study Completion: 2024-12-30

Recruitment & Eligibility

• Status: RECRUITING
• Sex: All
• Target Recruitment: 40

Inclusion Criteria

• Patients from 18 to 50 years old scheduled to undergo anterior cruciate ligament reconstruction

Exclusion Criteria

• peripheral neuropathy
• pre-existing femoral neuropathy
• diabetes mellitus
• alcoholism
• drug addiction
• cancer with chemotherapy
• chronic pain state
• Negative of the patient to participate in the study.

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Arm && Interventions

Group	Intervention	Description
Adductor canal block	Adductor canal block	Injection of local anaesthetics under ultrasound guidance in the adductor canal by the anaesthesiologist prior the surgery, after inducction of general anesthesia.
Genicular nerve block	Adductor canal block	Injection of local anaesthetics under ultrasound guidance in the genicular nerves ( Superomedial genicular nerve, superolateral genicular nerve and inferomedial genicular nerve) by the anaesthesiologist prior the surgery, after inducction of general anesthesia.

Primary Outcome Measures

Name	Time	Method
Pain assessed by NRS at PACU	up to 6 hours postoperative	Numerical raiting score (NRS) 0-10 (0= No pain; 10=maximum pain)
Opioid consumption at PACU	up to 6 hours postoperative	Metadone consumption in mg.

Secondary Outcome Measures

Name	Time	Method
Pain score at home	up to 24 hours	Numerical raiting score (NRS) 0-10 (0= No pain; 10=maximum pain)
Quality of rest	First night	Sleep or wake-up during first night (Pain) (Awake because of pain: Yes / NO)

Trial Locations

Locations (1)

Hospital Clinic; 🇪🇸 Barcelona, Spain