Comparing BiFeS and iPACK nerve blocks for pain after knee replacement
Comparison of Postoperative Analgesic Effects of Two Different Anesthesia Techniques in Knee Arthroplasty: Nerve Blocks Named BiFeS and iPACK
This trial will test if adding the BiFeS nerve block to an adductor canal block controls pain and reduces opioid use more than adding the iPACK block in people having total knee replacement.
Quick facts
| Phase | Not applicable |
|---|---|
| Study type | Interventional |
| Enrollment | 88 (estimated) |
| Ages | 18 Years to 80 Years |
| Sex | All |
| Sponsor | Amasya University Academic / other |
| Locations | 1 site (Amasya) |
| Trial ID | NCT07360392 on ClinicalTrials.gov |
What this trial studies
This is a prospective, randomized, double-blind, parallel two-group trial enrolling patients scheduled for unilateral total knee arthroplasty. All participants receive an adductor canal block (ACB) and are randomized 1:1 to receive either the iPACK block or the newer BiFeS (biceps femoris short head) fascial plane block, which targets posterolateral knee sensory innervation while sparing motor function. Postoperative outcomes include visual analog pain scores, opioid consumption, early mobilization measures, and quality of recovery (QoR-15). The trial aims to compare analgesic efficacy and functional recovery between the two motor-sparing block combinations.
Who should consider this trial
Good fit: Adults with ASA physical status I–III scheduled for unilateral primary total knee arthroplasty who can receive regional anesthesia and comply with follow-up are ideal candidates.
Not a fit: Patients scheduled for revision or bilateral arthroplasty, those with peripheral neuropathy, chronic opioid use, coagulopathy, or contraindications to regional blocks are unlikely to benefit or be eligible.
Why it matters
Potential benefit: If successful, this approach could provide better pain relief with less opioid use and faster early mobilization while preserving leg muscle strength.
How similar studies have performed: Combinations of motor-sparing blocks such as ACB plus iPACK have shown improved pain control in prior trials and meta-analyses, but the BiFeS block is a novel technique with limited prior clinical data.
Eligibility criteria
Show full inclusion / exclusion criteria
Inclusion Criteria: * Scheduled for unilateral total knee arthroplasty * Classified as ASA physical status I-III Exclusion Criteria: * Scheduled for revision arthroplasty or bilateral surgery * Allergy to local anesthetics or contraindication to regional blocks * Neurological disorders, peripheral neuropathy, or conditions affecting lower extremity muscle strength * Coagulopathy or receiving anticoagulant therapy * History of severe liver, kidney, or heart failure * Chronic opioid use or history of substance abuse * Patients experiencing intraoperative complications (e.g., excessive bleeding) * Cases in which adequate sensory blockade is not achieved after the block
Where this trial is running
Amasya
- Amasya University Sabuncuoğlu Şerefeddin Training and Research Hospital — Amasya, Turkey (Türkiye) (Recruiting)
Study contacts
- Study coordinator: Bülent M Çam, MD
- Email: bulentmericcam@gmail.com
- Phone: +90 534 8156011
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.