Ultrasound-Guided Popliteal Plexus Block Versus Fascia Iliaca Block After Total Knee Arthroplasty

NCT05390450 | Completed

• 1 other identifier: 35431/4/22
• Study Type: interventional
• Target: 60
• Locations: 1 country
• Sites: 1

Brief Summary

This study aims to investigate the effect of the Popliteal Plexus Block versus Fascia Iliaca Block on postoperative pain after total knee arthroplasty.

Conditions

Total Knee Arthroplasty; Popliteal Plexus Block; Fascia Iliaca Block

Outcome Measures

Primary Outcomes (1)

• Total intravenous (IV) morphine consumption

  Total intravenous (IV) morphine consumption during the first postoperative 24 hours, postoperatively.

  24 hours postoperatively.

Secondary Outcomes (4)

• First analgesic request

  24 hours postoperatively

• Pain level score

  24 hours postoperatively

• Rehabilitation

  24 hours postoperatively

• Patient's satisfaction level

  24 hours postoperatively

Study Arms (2)

Ultrasound-Guided Popliteal Plexus Block

EXPERIMENTAL

Patients in this group will receive Popliteal plexus block.

Device: Ultrasound-Guided Popliteal Plexus Block

Ultrasound-Guided Fascia Iliaca block

EXPERIMENTAL

Patients in this group will receive Fascia Iliaca block.

Device: Ultrasound-Guided Fascia Iliaca block

Interventions

Ultrasound-Guided Popliteal Plexus Block DEVICE

Patients in this group will receive Popliteal plexus block. Prior to Popliteal plexus block, the proximal end of the adductor canal will be identified. The transducer will be slid distally along the femoral artery until the artery deviated away from the sartorius muscle in the distal part of the adductor canal towards the adductor hiatus. The nerve block needle will be inserted from the anterolateral end of the transducer and advanced in-plane through the medial vastus muscle. The endpoint of injection will be inside the distal end of the adductor canal close to the adductor hiatus. The injection will be adjacent to the femoral artery, between the medial vastus muscle and the adductor magnus muscle. The Popliteal plexus block will be carried out with 10 mL of local anesthetic mixture, containing 50 mg of bupivacaine and 0.05 mg of epinephrine.

Ultrasound-Guided Popliteal Plexus Block

Ultrasound-Guided Fascia Iliaca block DEVICE

Patients will be placed in a supine position, and the skin will be cleaned aseptically. The inguinal ligament from the anterior superior iliac spine to the pubic tubercle will be drawn on the skin and divided into 3 parts. The injection point was 1 cm caudally from the point where the lateral and middle part of the inguinal ligament met. The skin and deep tissues were infiltrated with 1% lidocaine. A 18G nerve block needle will be inserted into the skin perpendicularly until the first (fascia lata) and second loss of resistance (fascia iliaca) will be felt. Following aspiration to exclude intravascular injection, 40 mL of 0.25% bupivacaine (1-1.5 mg/kg), which will be prepared under aseptic conditions, and then injected. Sensorial block will be evaluated using the pinprick test 20 minutes after injection for areas of the thigh innervated by the femoral, lateral cutaneous and obturator nerves.

Ultrasound-Guided Fascia Iliaca block

Eligibility Criteria

• Age: 40 Years - 75 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Age 40 - 75 years.
• Both sexes.
• American Society of Anesthesiologists (ASA) score I-II.
• Scheduled for unilateral, primary TKA under spinal anesthesia.

You may not qualify if:

• Coagulopathy.
• Diabetes.
• Obesity.
• Heart failure.
• kidney failure.
• Liver failure.
• Reduced sensation on the lower limb.
• Daily intake of opioids.
• Contraindication to any drug used in the study.

Sponsors & Collaborators

• Tanta University: lead

Study Sites (1)

Tanta University Hospitals

Tanta, Elgharbia, 31527, Egypt

Location

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: DOUBLE
• Who Masked: PARTICIPANT, OUTCOMES ASSESSOR
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Lecturer of Anesthesiology, Surgical Intensive Care and Pain Medicine, Faculty of Medicine

Study Record Dates

• First Submitted: May 18, 2022
• First Posted: May 25, 2022
• Study Start: June 1, 2022
• Primary Completion: March 31, 2023
• Study Completion: March 31, 2023
• Last Updated: April 21, 2023

Record last verified: 2023-04

Data Sharing

• IPD Sharing: Will share
• Shared Documents: STUDY PROTOCOL
• Time Frame: One year after the end of the study.
• Access Criteria: The protocol will available under reasonable request from the corresponding author.

Locations

EG (1)