Comparison of Anterior Sciatic Nerve Block and Adductor Magnus Muscle Plane Block for Anterior Cruciate Ligament Surgery

NCT07601529 | Completed

• 1 other identifier: B.30.2.ATA.0.01.00/761
• Study Type: interventional
• Target: 90
• Locations: 1 country
• Sites: 1

Brief Summary

Anterior cruciate ligament (ACL) reconstruction is frequently associated with moderate-to-severe postoperative pain despite its arthroscopic nature, owing to the complex sensory innervation of the knee involving the femoral, sciatic, and obturator nerves. Multimodal analgesic strategies, particularly peripheral nerve blocks, are therefore widely used to improve postoperative pain control and reduce opioid consumption. Although anterior sciatic nerve block can be combined with adductor canal block in the supine position, its application may be technically challenging because of the deep localization of the sciatic nerve. Recently, adductor magnus muscle plane block has emerged as a potentially easier alternative by indirectly targeting the terminal branches of the sciatic nerve through fascial plane spread. In this study, we compared the efficacy of anterior sciatic nerve block and adductor magnus muscle plane block, both combined with adductor canal block.

Conditions

ANTERIOR CRUCIATE LIGAMENT RECONSTRUCTION

Keywords

Anterior Sciatic Nerve Block; Adductor Magnus Muscle Plane Block; Adductor Canal Block; Anterior Cruciate Ligament Surgery

Outcome Measures

Primary Outcomes (1)

• Opioid consumption

  Postoperative opioid consumption

  0-4 hours, 4-8 hours, 8-24 hours, Total 24-hour

Secondary Outcomes (4)

• Pain Scores (VAS) at Rest and During Movement

  PACU, 1st hour, 2nd hours, 4th hours, 8th hours, 12th hours, 24th hours

• Adverse Effects

  up to 24 hours

• Evaluation of Nerve Blockade after Nerve Block Application

  5., 10., 15., 20., 30., and 45. minutes

• Quadriceps and Anterior Tibialis Muscle Strength

  4th hours, 8th hours, 12th hours, 24th hours, 48th hours

Study Arms (3)

Adductor Canal Block

ACTIVE COMPARATOR

Participants in this arm will receive an ultrasound-guided adductor canal block using 20 mL of 0.25% bupivacaine. Blocks will be performed under sterile ultrasound guidance by an experienced anesthesiologist who will not participate in postoperative assessments. All patients will receive standardized spinal anesthesia and perioperative analgesia.

Procedure: Adductor canal block

Adductor Canal + Anterior Sciatic nerve block

ACTIVE COMPARATOR

Participants in this arm will receive an ultrasound-guided anterior sciatic nerve block (20 mL of 0.25% bupivacaine) and adductor canal block (20 mL of 0.25% bupivacaine). Blocks will be performed under sterile ultrasound guidance by an experienced anesthesiologist who will not participate in postoperative assessments. All patients will receive standardized spinal anesthesia and perioperative analgesia.

Procedure: Adductor canal block; Procedure: Anterior sciatic nerve block

Adductor Canal + Adductor magnus plane block

ACTIVE COMPARATOR

Participants in this arm will receive an ultrasound-guided adductor magnus plane block (20 mL of 0.25% bupivacaine) and an adductor canal block (20 mL of 0.25% bupivacaine). Blocks will be performed under sterile ultrasound guidance by an experienced anesthesiologist who will not participate in postoperative assessments. All patients will receive standardized spinal anesthesia and perioperative analgesia.

Procedure: Adductor canal block; Procedure: Adductor magnus plane block

Interventions

Adductor canal block PROCEDURE

Ultrasound transducer was placed perpendicular to the thigh to visualize the sartorius muscle, femoral artery and vein, and the adductor canal. Following infiltration of the skin and subcutaneous tissue with 2% lidocaine, a 22-gauge, 10-cm echogenic needle was advanced in-plane from lateral to medial toward the adductor canal. After confirming correct needle tip placement with 2 mL of 0.9% NaCl solution, 20 mL of 0.25% bupivacaine was administered.

Also known as: ACB

Adductor Canal + Adductor magnus plane block; Adductor Canal + Anterior Sciatic nerve block; Adductor Canal Block

Anterior sciatic nerve block PROCEDURE

An ultrasound transducer was placed perpendicular to the anterior thigh. The sartorius muscle, femoral artery and vein, adductor longus muscle, adductor magnus muscle, and the sciatic nerve were identified. Following infiltration of the skin and subcutaneous tissue with 2% lidocaine, a 22-gauge, 10-cm echogenic needle was advanced toward the sciatic nerve under ultrasound guidance. Nerve stimulation was applied, and an appropriate motor response in the sciatic nerve distribution was obtained at 0.2-0.5 mA. After injection of 2 mL of 0.9% saline and visualization of perineural spread to confirm correct needle placement, 20 mL of 0.25% bupivacaine was administered.

Also known as: ASB

Adductor Canal + Anterior Sciatic nerve block

Adductor magnus plane block PROCEDURE

An ultrasound transducer was placed perpendicular to the thigh to visualise the sartorius muscle, femoral artery and vein, adductor longus, and the underlying adductor magnus muscle. Following infiltration of the skin and subcutaneous tissue with 2% lidocaine, a 22-gauge, 10-cm echogenic needle was advanced until the posterior fascia of the adductor magnus muscle was penetrated. After injection of 2 mL of 0.9% NaCl solution, correct needle placement was confirmed by observing fluid spread beneath the posterior surface of the adductor magnus muscle. Subsequently, 20 mL of 0.25% bupivacaine was administered.

Also known as: AMB

Adductor Canal + Adductor magnus plane block

Eligibility Criteria

• Age: 18 Years - 45 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64)

You may qualify if:

• Anesthesiologists (ASA) physical status I-II,
• Scheduled for arthroscopic anterior cruciate ligament reconstruction

You may not qualify if:

• cardiovascular disease,
• hepatic dysfunction,
• coagulopathy or current use of anticoagulant therapy,
• inability to cooperate,
• known allergy to any of the study medications,
• refusal to participate in the study

Sponsors & Collaborators

• Ataturk University: lead

Study Sites (1)

Ataturk Universtiy

Erzurum, 25100, Turkey (Türkiye)

Location

Study Officials

• Samet Kapakin, Professor

  Ataturk University

  STUDY CHAIR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: DOUBLE
• Who Masked: PARTICIPANT, INVESTIGATOR
• Masking Details: Participants and outcome assessors will remain blinded to group allocation. The anesthesiologist performing the block procedures will not participate in postoperative assessments.
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Assoc. Prof.

Study Record Dates

• First Submitted: May 11, 2026
• First Posted: May 22, 2026
• Study Start: April 1, 2024
• Primary Completion: March 1, 2026
• Study Completion: April 1, 2026
• Last Updated: May 22, 2026

Record last verified: 2026-05

Locations

TU (1)