sACB vs cACB in TKA

NCT07581886 | Not Yet Recruiting DMC

• 1 other identifier: 4-2026-0299
• Study Type: interventional
• Target: 78
• Locations: 0 countries
• Sites: N/A

Brief Summary

This study compares the analgesic efficacy of single-dose adductor canal block (sACB) versus continuous-dose adductor canal block (cACB) for postoperative pain management in total knee replacement patients. To ensure a high level of clinical accuracy, the investigation specifically focuses on a cACB cohort where ultrasound confirmation ensures the catheter remains correctly positioned for a full 48 hours. Participants are assigned to groups using a 1:1 randomization protocol via computer-generated tables to eliminate selection bias. Clinical consistency is maintained by using identical pharmacological agents across both groups: 0.5% Heavy Bupivacaine for spinal anesthesia and 0.5% ropivacaine with 1:200,000 epinephrine for the nerve block itself. Furthermore, both groups adhere to a standardized multimodal analgesic schedule to control for external variables. In the cACB group, intravenous patient-controlled analgesia (IV PCA) serves as a designated rescue therapy should the catheter fail. The primary technical evaluation occurs 48 hours post-surgery, utilizing ultrasound to verify catheter placement and quantify pain levels. Beyond immediate recovery, the study evaluates long-term success through Patient-Reported Outcome Measures (PROMs) at a 12-week follow-up, focusing on functional restoration and the patient's overall quality of life. By isolating the variable of catheter stability, the research aims to provide a definitive comparison of whether the continuous delivery of local anesthetic offers a statistically significant clinical advantage over a single-dose administration in the context of modern orthopedic recovery protocols.

Conditions

Arthroplasty; Replacement; Knee

Outcome Measures

Primary Outcomes (1)

• postoperative pain score at rest (Area Under Curve, AUC)

  48-hour postoperative pain score at rest (Area Under Curve, AUC) using NRS.

  postoperative 48 hours

Study Arms (2)

Continuous ACB

ACTIVE COMPARATOR

Procedure: Continuous ACB

Single-shot ACB

SHAM COMPARATOR

Procedure: Single-shot ACB

Interventions

Continuous ACB PROCEDURE

Adductor canal block, a lower extremity nerve block technique for postoperative pain control, is performed under ultrasound guidance for patients undergoing total knee arthroplasty, and is carried out by inserting a catheter. The catheter is connected to a PCA pump following insertion, with a continuous infusion rate for two days post-surgery.

Continuous ACB

Single-shot ACB PROCEDURE

Adductor canal block, a lower extremity nerve block technique for postoperative pain control, is performed under ultrasound guidance for patients undergoing total knee arthroplasty, and is carried out by a single-shot local anesthetic administration.

Single-shot ACB

Eligibility Criteria

• Age: 40 Years - 80 Years
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Age 40-80 yrs
• Scheduled for unilateral total knee arthroplatsy
• ASA I-III
• BMI 18-35 kg/㎡
• Able to read and understand consent form

You may not qualify if:

• Allergy to local anesthetics
• Infection at the block site
• History of neuropathy or peripheral nerve disease
• Coagulation disorders or use of anticoagulants (if discontinuation is not possible)
• Communication disorders or cognitive impairment
• Chronic opioid use (≥30 MME/day, 3 months or more)
• Severe chronic pain (NRS ≥7/10, 3 months or more)
• Renal impairment (eGFR \<30 mL/min/1.73m²)
• Hepatic impairment (Child-Pugh C)
• Blood coagulation disorders
• Pregnancy

Sponsors & Collaborators

• Yonsei University: lead

Central Study Contacts

eunjung Kim

CONTACT

natlis@yuhs.ac

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: PARTICIPANT
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: May 6, 2026
• First Posted: May 12, 2026
• Study Start: May 18, 2026
• Primary Completion (Estimated): January 10, 2028
• Study Completion (Estimated): January 31, 2028
• Last Updated: May 12, 2026

Record last verified: 2026-05

Data Sharing

• IPD Sharing: Will not share