Comparison of Ultrasound-Guided Lumbar Erector Spinae Plane Block and Adductor Canal Block on Postoperative Analgesia Management in Patients Undergoing Knee Arthroplasty
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 发起方
- 入组人数
- 60
- 试验地点
- 2
- 主要终点
- opioid consumption
研究概览
简要总结
Total knee arthroplasty (TKA) is a surgical procedure frequently associated with moderate-to-severe postoperative pain. While Adductor Canal Block (ACB) has demonstrated analgesic efficacy in TKA, the Erector Spinae Plane Block (ESPB) is also being utilized as part of multimodal analgesia for postoperative pain management in lower extremity surgeries. Currently, there is a gap in the literature as no studies have directly compared the efficacy of ACB and ESPB for pain management following TKA. The primary objective of this study is to compare the efficacy of these two analgesic methods in the context of postoperative analgesia management after total knee arthroplasty.
详细描述
In our clinic, various regional blocks are applied for analgesia or anesthesia purposes in many surgeries, including knee surgery. For knee surgery, adductor canal block, lumbar epidural analgesia, genicular block, erector spinae plane block, and iPACK block can be used. In our clinic, erector spinae plane block and adductor canal block are routinely applied to knee surgery patients. In our study, we aimed to contribute to the literature by comparing patient satisfaction surveys and pain follow-up in patients undergoing knee arthroplasty who received adductor canal block versus lumbosacral erector spinae plane block, both applied with PROSPECT protocols for postoperative analgesia.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Treatment
- 盲法
- Double (Participant, Outcomes Assessor)
盲法说明
he patient and the outcomes assessor who performs postoperative pain evaluation will not know the group
入排标准
- 年龄范围
- 18 Years 至 65 Years（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Patients aged 18-65 years Patients scheduled for elective total knee arthroplasty under spinal anesthesia ASA physical status I-II Written informed consent
排除标准
- •Refusal to participate Coagulopathy or inability to discontinue anticoagulant therapy appropriately Allergy or toxicity history to local anesthetics or opioids Infection at the injection site Severe cardiac, hepatic, or renal failure Diabetes mellitus-related neuropathy Peripheral neuropathy or motor-sensory deficit in the relevant extremity Psychiatric disease, cognitive impairment, or inability to cooperate Substance or alcohol abuse Pregnancy, suspected pregnancy, or breastfeeding Body mass index >40 kg/m² Failed spinal anesthesia or need for additional intraoperative anesthesia/analgesia
研究组 & 干预措施
Adductor canal block
Patients will receive an adductor canal block preoperatively.
干预措施: Postoperative analgesia management (Other)
Erector spinae plane block
Patients will receive a lumbosacral erector spinae plane block in the preoperative period.
干预措施: Postoperative analgesia management (Other)
结局指标
主要结局
opioid consumption
时间窗: 0, 2, 4, 8, 16, 24 and 48 hours
Tramadol will be prepared as 5mg/ml and patient-controlled analgesia will be administered without basal infusion, with a locking time of 20 minutes and a bolus dose of 10mg.
次要结局
- Global recovery scoring system (patient satisfaction scale)(The quality of recovery will be evaluated out of a total of 150 points according to the QoR-15 test to be applied at the portoperative 48th hour.)
- Determine the time to first postoperative mobilization (The Timed Up and Go - TUG test):(The Timed Up and Go (TUG) test will be performed at the 20th minute after the preoperative block.)
- Postoperative pain scores (Numerical rating scale) (0-meaning "no pain" to 10-meaning "worst pain imaginable")(The NRS scores of the patients will be evaluated at the postoperative 0, 2, 4, 8, 16, 24 and 48 hours.)
- Global recovery scoring system (patient satisfaction scale)(The quality of recovery will be evaluated out of a total of 150 points according to the QoR-15 test to be applied at the portoperative 48th hour.)
- Determine the time to first postoperative mobilization (The Timed Up and Go - TUG test):(The Timed Up and Go (TUG) test will be performed at the 20th minute after the preoperative block.)
研究者
Mursel Ekinci
assoc prof
Bursa City Hospital