Adding targeted posterior knee nerve blocks to the adductor canal block for pain control after total knee replacement
Comparison of the Effectiveness of "Sciatic Nerve", "Biceps Femoris Short Head (BiFeS)" and "Interspace Between the Popliteal Artery and the Capsule of the Posterior Knee (IPACK)" Blocks Added to the Adductor Canal Block for Postoperative Pain Control in Patients Undergoing Primary Total Knee Arthroplasty: A Prospective, Randomized Controlled Clinical Trial
This trial will test whether adding one of three different posterior knee nerve blocks to a standard adductor canal block reduces pain and opioid use for adults having a single total knee replacement.
Quick facts
| Phase | Not applicable |
|---|---|
| Study type | Interventional |
| Enrollment | 102 (estimated) |
| Ages | 18 Years to 75 Years |
| Sex | All |
| Sponsor | Erzincan University Academic / other |
| Locations | 1 site (Erzincan, Merkez) |
| Trial ID | NCT07242170 on ClinicalTrials.gov |
What this trial studies
This is a prospective, single-center, double-blind, randomized controlled trial enrolling about 102 adults aged 18–75 undergoing elective unilateral primary total knee arthroplasty. All participants receive a standard adductor canal block and are randomized to receive one of three supplementary posterior knee blocks (sciatic, BiFeS, or IPACK) performed under ultrasound guidance. Outcomes include postoperative pain scores, opioid consumption, motor function, early mobilization, and block-related complications measured through the immediate postoperative period and early recovery. The protocol follows institutional ethics approval and written informed consent with standard spinal anesthesia used for surgery.
Who should consider this trial
Good fit: Adults 18–75 years old with ASA physical status I–III scheduled for elective unilateral primary total knee arthroplasty at the enrolling hospital are appropriate candidates.
Not a fit: Patients having revision or bilateral knee arthroplasty, ASA IV or higher, neuromuscular disease, significant neurological dysfunction, bleeding diathesis, pregnancy, or those unable to consent are unlikely to benefit from this protocol.
Why it matters
Potential benefit: If successful, the approach could provide better pain relief after knee replacement with lower opioid needs and preserved motor function to aid earlier mobilization.
How similar studies have performed: Prior work shows the sciatic block is effective for posterior knee pain but causes motor weakness, while motor-sparing techniques like IPACK have promising results; the BiFeS block is a newer approach with limited published data.
Eligibility criteria
Show full inclusion / exclusion criteria
Inclusion Criteria: * Patients classified as American Society of Anesthesiologists (ASA) physical status I-III * Patients undergoing primary total knee arthroplasty * Patients undergoing unilateral total knee arthroplasty * Patients between 18 and 75 years of age Exclusion Criteria: * Patients classified as American Society of Anesthesiologists (ASA) physical status IV or higher * Patients undergoing revision total knee arthroplasty * Patients undergoing bilateral total knee arthroplasty * Patients with neuromuscular disease * Patients who decline to participate in the study * Patients with cognitive dysfunction * Patients with known drug allergies * Patients with a history of local anesthetic systemic toxicity * Patients with neurological dysfunction * Patients with bleeding diathesis * Pregnant patients
Where this trial is running
Erzincan, Merkez
- Erzincan Binali Yıldırım Üniversitesi — Erzincan, Merkez, Turkey (Türkiye) (Recruiting)
Study contacts
- Study coordinator: mustafa somunkıran, anesthesiology resident
- Email: msomunkran@gmail.com
- Phone: +905536327870
How to participate
- Review the eligibility criteria above with your treating physician.
- Visit the official trial page on ClinicalTrials.gov for the most current contact information and recruitment status.
- Contact the listed study coordinator or principal investigator to request pre-screening. Pre-screening is free and never obligates you to enroll.