Comparison of Ultrasound-Guided Lumbar ESPB and ACB for Knee Arthroplasty

NCT07115771 | Recruiting

• 1 other identifier: Bursa Şehir Hastanesi 12
• Study Type: interventional
• Target: 60
• Locations: 1 country
• Sites: 1

Brief Summary

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.

Conditions

Total Knee Anthroplasty

Keywords

Postoperative Analgesia; adductor canal block; erector spinae plane block; Total Knee Anthroplasty

Outcome Measures

Primary Outcomes (1)

• opioid consumption

  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.

  0, 2, 4, 8, 16, 24 and 48 hours

Secondary Outcomes (3)

• 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.

Study Arms (2)

Adductor canal block

ACTIVE COMPARATOR

Patients will receive an adductor canal block preoperatively.

Other: Postoperative analgesia management

Erector spinae plane block

ACTIVE COMPARATOR

Patients will receive a lumbosacral erector spinae plane block in the preoperative period.

Other: Postoperative analgesia management

Interventions

Postoperative analgesia management OTHER

After determining the L5-S1 level with ultrasound guidance, an 80 mm block needle (Stimuplex Ultra®, Braun, Melsungen, Germany) will be advanced in a cranio-caudal direction. Following hydrodissection, 30 ml of 0.25% bupivacaine local anesthetic solution containing 7.5 mcg of epinephrine (1:200,000) will be administered.

Erector spinae plane block

Eligibility Criteria

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

You may qualify if:

• patients who underwent total knee arthroplasty surgery
• ASA I-II patients

You may not qualify if:

• Patient refusal to participate in the study
• Patients with coagulopathy
• Patients history with local anesthetic allergy or toxicity
• Patients with liver and kidney failure
• Mentally disabled patients
• Presence of infection at the injection site
• Pregnant, suspected pregnant, or breastfeeding mothers

Sponsors & Collaborators

• Bursa City Hospital: lead
• Emre ULUSOY: collaborator

Study Sites (1)

Bursa City Hospital

Bursa, Nilüfer, 16110, Turkey (Türkiye)

RECRUITING

Related Publications (7)

• Tran J, Chan VWS, Peng PWH, Agur AMR. Evaluation of the proximal adductor canal block injectate spread: a cadaveric study. Reg Anesth Pain Med. 2019 Dec 25:rapm-2019-101091. doi: 10.1136/rapm-2019-101091. Online ahead of print.

  PMID: 31879373 BACKGROUND

• Tao Y, Zheng SQ, Xu T, Wang G, Wang Y, Wu AS, Yue Y. Median effective volume of ropivacaine 0.5% for ultrasound-guided adductor canal block. J Int Med Res. 2018 Oct;46(10):4207-4213. doi: 10.1177/0300060518791685. Epub 2018 Aug 20.

  PMID: 30124351 BACKGROUND

• Gupta A, Kaur J, Kumar R. Unilateral sacral erector spinae plane block for lower limb surgery in children. Anaesth Rep. 2022 Dec 14;10(2):e12199. doi: 10.1002/anr3.12199. eCollection 2022 Jul-Dec.

  PMID: 36530341 BACKGROUND

• Browne W, Nair BKR. The Timed Up and Go test. Med J Aust. 2019 Jan;210(1):13-14.e1. doi: 10.5694/mja2.12045. Epub 2018 Dec 28. No abstract available.

  PMID: 30636313 BACKGROUND

• Diwan S, Nair A. Lumbar erector spinae plane block obtunding knee and ankle reflexes. Saudi J Anaesth. 2021 Apr-Jun;15(2):222-224. doi: 10.4103/sja.SJA_79_20. Epub 2021 Apr 1.

  PMID: 34188648 BACKGROUND

• Kaya C, Dost B, Tulgar S. Sacral Erector Spinae Plane Block Provides Surgical Anesthesia in Ambulatory Anorectal Surgery: Two Case Reports. Cureus. 2021 Jan 9;13(1):e12598. doi: 10.7759/cureus.12598.

  PMID: 33585088 BACKGROUND

• Selvi O, Azizoglu M, Temel G, Tulgar S, Chitneni A, Cinar EN, Ozer Z, Gurkan Y. Translation and Validation of the Turkish Version of the Quality of Postoperative Recovery Score QoR-15: A Multi-Centred Cohort Study. Turk J Anaesthesiol Reanim. 2022 Dec;50(6):443-448. doi: 10.5152/TJAR.2022.21417.

  PMID: 36511494 BACKGROUND

Central Study Contacts

Mursel Ekinci

CONTACT

+905067137596; drmurselekinci@gmail.com

Emre ULUSOY

CONTACT

+905379492799; emreulusoy36@gmail.com

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: DOUBLE
• Who Masked: PARTICIPANT, OUTCOMES ASSESSOR
• Masking Details: he patient and the outcomes assessor who performs postoperative pain evaluation will not know the group
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER GOV
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: assoc prof

Study Record Dates

• First Submitted: August 4, 2025
• First Posted: August 11, 2025
• Study Start: August 15, 2025
• Primary Completion: April 15, 2026
• Study Completion (Estimated): May 15, 2026
• Last Updated: November 25, 2025

Record last verified: 2025-11

Data Sharing

• IPD Sharing: Will not share

Locations

TU (1)