Biceps Femoris Short Head (BiFeS) Block and Adductor Canal Block for Postoperative Analgesia Following Total Knee Arthroplasty

NCT07577869 | Not Yet Recruiting

• 1 other identifier: KSH-ANES-2026/77
• Study Type: interventional
• Target: 60
• Locations: 1 country
• Sites: 1

Brief Summary

This prospective randomized controlled study aims to evaluate the effect of ultrasound-guided Biceps Femoris Short Head (BiFeS) block combined with adductor canal block on postoperative opioid consumption and pain control in patients undergoing elective total knee arthroplasty under spinal anesthesia. A total of 60 patients aged 18-80 years with ASA physical status I-III scheduled for unilateral elective total knee arthroplasty will be randomized into two groups. The intervention group will receive spinal anesthesia followed by BiFeS block and adductor canal block before surgery, in addition to standard multimodal analgesia and postoperative morphine patient-controlled analgesia (PCA). The control group will receive spinal anesthesia and standard multimodal analgesia with postoperative morphine PCA without peripheral nerve block. The primary outcome is total morphine consumption during the first 24 postoperative hours. Secondary outcomes include postoperative pain scores assessed by Numeric Rating Scale (NRS), time to first analgesic requirement, time to first foot movement, and Quality of Recovery-15 (QoR-15) scores.

Conditions

Postoperative Pain Following Knee Arthroplasty; Total Knee Arthroplasty

Keywords

Postoperative Pain; BiFeS; BiFeS and Adductor Canal Block

Outcome Measures

Primary Outcomes (1)

• Total Morphine Consumption in 24 Hours

  Total cumulative morphine consumption measured from patient-controlled analgesia device during the first 24 postoperative hours.

  Within the first 24 hours after surgery

Secondary Outcomes (4)

• Numeric Rating Scale (NRS) Pain Scores

  Postoperative 1, 6, 12, and 24 hours

• Time to First Analgesic Requirement

  24 hours

• Time to First Foot Movement

  24 hours

• QoR-15 Score

  24 hours postoperatively

Study Arms (2)

Block Group

EXPERIMENTAL

Patients receive spinal anesthesia followed by ultrasound-guided BiFeS block and adductor canal block before surgery, plus standard multimodal analgesia and morphine PCA.

Procedure: Procedure: Biceps Femoris Short Head Block

Multimodal Analgesia Group

ACTIVE COMPARATOR

Patients receive spinal anesthesia only, followed by standard multimodal analgesia and morphine PCA.

Procedure: Procedure: Spinal Anesthesia

Interventions

Procedure: Biceps Femoris Short Head Block PROCEDURE

Patients will receive spinal anesthesia followed by ultrasound-guided Biceps Femoris Short Head (BiFeS) block using 25 mL of 0.25% bupivacaine and adductor canal block using 15 mL of 0.25% bupivacaine before surgery. Standard multimodal analgesia will be provided using intravenous paracetamol and dexketoprofen, along with postoperative patient-controlled analgesia with morphine for 24 hours.

Also known as: Procedure: Adductor Canal Block, Drug: Morphine PCA, Drug: Paracetamol, Drug: Dexketoprofen, Drug: Fentanyl

Block Group

Procedure: Spinal Anesthesia PROCEDURE

Patients will receive spinal anesthesia without peripheral nerve block. Standard multimodal analgesia will be provided using intravenous paracetamol and dexketoprofen, along with postoperative patient-controlled analgesia with morphine for 24 hours.

Also known as: Drug: Morphine PCA, Drug: Paracetamol, Drug: Dexketoprofen, Drug:Fentanyl

Multimodal Analgesia Group

Eligibility Criteria

• Age: 18 Years - 80 Years
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Patients aged 18 and older
• ASA I-III
• Patients scheduled for elective unilateral knee replacement
• Eligibility for and consent to spinal anesthesia

You may not qualify if:

• History of allergy or anaphylaxis to local anesthetics, animal gelatin, or chlorhexidine
• Bleeding diathesis/inability to discontinue anticoagulants
• Infection (at the injection site/sepsis)
• Neurological disorders or cognitive impairment affecting pain perception
• Pregnancy, breastfeeding
• Patients under 18 years of age

Sponsors & Collaborators

• Ömer Kayar: lead

Study Sites (1)

Kayseri City Hospital

Kayseri, Kocasinan, 38080, Turkey (Türkiye)

Location

MeSH Terms

Conditions

Pain, Postoperative

Interventions

Acetaminophen; dexketoprofen trometamol; Fentanyl

Condition Hierarchy (Ancestors)

Postoperative Complications; Pathologic Processes; Pathological Conditions, Signs and Symptoms; Pain; Neurologic Manifestations; Signs and Symptoms

Intervention Hierarchy (Ancestors)

Acetanilides; Anilides; Amides; Organic Chemicals; Aniline Compounds; Amines; Piperidines; Heterocyclic Compounds, 1-Ring; Heterocyclic Compounds

Central Study Contacts

Omer Kayar, Medicinae Doctor

CONTACT

+90 531 578 90 37; dr.omer.kayar@hotmail.com

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: TRIPLE
• Who Masked: PARTICIPANT, CARE PROVIDER, OUTCOMES ASSESSOR
• Purpose: SUPPORTIVE CARE
• Intervention Model: PARALLEL
• Sponsor Type: OTHER GOV
• Responsible Party: SPONSOR INVESTIGATOR
• PI Title: Anesthesiology and Reanimation Doctor

Study Record Dates

• First Submitted: May 5, 2026
• First Posted: May 11, 2026
• Study Start (Estimated): June 2, 2026
• Primary Completion (Estimated): June 2, 2027
• Study Completion (Estimated): July 2, 2027
• Last Updated: May 13, 2026

Record last verified: 2026-05

Data Sharing

• IPD Sharing: Will not share

Locations

TU (1)