Comparison Between Combined Biceps Femoris Short Head Block and Adductor Canal Block Versus Genicular Nerve Block

NCT07418307 | Not Yet Recruiting DMC

• 1 other identifier: ZU-IRB#2002/28-Jan-2026
• Study Type: interventional
• Target: 50
• Locations: 1 country
• Sites: 1

Brief Summary

The purpose of this study is to compare the analgesic outcomes (time to first analgesic request, total amount of analgesic consumption, and pain scores) following total knee arthroplasty by either combined biceps femoris short head block and adductor canal block or genicular nerve block in elderly patients.

Conditions

Knee Arthroplasty, Total

Outcome Measures

Primary Outcomes (1)

• Time of first rescue analgesia (naluphine)

  to the duration from the block to the moment when the patient first requires or requests supplemental nalbuphine due to breakthrough pain

  24 hours postoperative

Secondary Outcomes (6)

• block performance time

  time of performance of the block

• Pain intensity

  30 minutesn2, 4, 8, 12, 18 , and 24 hours postoperative

• Total amount of rescue analgesia (nalbuphine)

  first 24 hours postoperative

• assess functional recovery

  at 12 hours and 24 hours postoperative

• patient's satisfaction

  24 hours postoperative

Study Arms (2)

Group (C)

ACTIVE COMPARATOR

The patient will receive combined biceps femoris short head block and adductor canal block

Other: Combined biceps femoris short head block and adductor canal block

Group(G)

ACTIVE COMPARATOR

The patient will receive genicular nerve block

Other: Genicular nerve block

Interventions

Combined biceps femoris short head block and adductor canal block OTHER

Adductor Canal Block high-frequency probe will be placed transversely on the anterior thigh midpoint between inguinal crease and medial condyle (depth 3-5 cm). The needle will be advanced in-plane from lateral to medial through sartorius or vastus medialis muscle toward the femoral artery. Then (10 ml of 0.25% bupivacaine and 2 mg dexamethasone) will be injected after negative aspiration, with confirming spread around the artery without vascular puncture. Biceps femoris short head block The probe will be placed on the distal posterior thigh to visualize biceps femoris muscle near the lateral supracondylar line of the femur. The needle will be inserted to the interface between biceps femoris and femur cortex. Then (25 ml of 0.25% bupivacaine and 2 mg dexamethasone), with observing muscle lift and circumferential spread along the bone surface .

Group (C)

Genicular nerve block OTHER

Position the patient will be placed in supine position with the knee slightly flexed via a pillow in the popliteal fossa. Use a high-frequency linear ultrasound transducer. Superolateral genicular nerve (SLGN): the transducer will be placed coronally over lateral femoral epicondyle, with sliding proximally to femur metaphysis; identifying artery between vastus lateralis fascia and bone. Superomedial genicular nerve (SMGN): the transducer will be placed coronally over medial femoral epicondyle, proximal to adductor tubercle at femur metaphysis; artery between vastus medialis fascia and bone. Inferomedial genicular nerve (IMGN): the transducer will be placed coronally over medial tibial condyle, distal to metaphysis; artery beneath medial collateral ligament. • Inferolateral genicular nerve (ILGN, optional): the transducer will be placed coronally over lateral tibial epicondyle to fibula head; artery between collateral ligament and tibia

Group(G)

Eligibility Criteria

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

You may qualify if:

• patient acceptance
• Physical status: ASA I, II and Ⅲ.
• Body mass index (BMI): 18.5 - 35 kg/m2.
• Type of operations: total knee arthroplasty.

You may not qualify if:

• Known hypersensitivity to dexamethasone or bupivacaine.
• Coagulation disorders or taking drugs affect surgical hemostasis.
• Patients with pre-existing neurological deficits.
• Uncooperative patient or with altered mental status.
• Patient with advanced cardiovascular or respiratory diseases or uncontrolled diabetes

Sponsors & Collaborators

• Zagazig University: lead

Study Sites (1)

Faculty of Medicine,Zagazig University

Zagazig, Egypt

Location

Related Publications (1)

• You D, Qin L, Li K, Li D, Zhao G, Li L.,et al. A meta-analysis on advantages of peripheral nerve block post-total knee arthroplasty. Korean J Pain 2021; 34:271-287.

  BACKGROUND

Study Officials

• Howida A Kamal, M.D

  faculty of medicine,zagazig university Egypt

  STUDY DIRECTOR

Central Study Contacts

Marwa M Medhat, M.D

CONTACT

01002828937; medhatmarwa9@gmail.com

Howida A Kamal, M.D

CONTACT

01225096755; K.Howida@yahoo.com

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: DOUBLE
• Who Masked: PARTICIPANT, CARE PROVIDER
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER GOV
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: assistant professor of anesthesia and surgical intensive care(Principal Investigator)

Study Record Dates

• First Submitted: February 4, 2026
• First Posted: February 18, 2026
• Study Start: February 15, 2026
• Primary Completion (Estimated): August 15, 2026
• Study Completion (Estimated): November 15, 2026
• Last Updated: February 18, 2026

Record last verified: 2026-02

Locations

EG (1)