Ultrasound Guided Combined Adductor Canal, Superior Genicular Nerves and Anterior Femoral Cutaneous Nerves Blocks in Comparison With Periarticular Local Anesthesia Infiltration in Primary Total Knee Arthroplasty

NCT07705230 | Completed

• 1 other identifier: REGIONAL BLOCKS IN TKA
• Study Type: interventional
• Target: 64
• Locations: 1 country
• Sites: 1

Brief Summary

Background: Pain management in total knee arthroplasty continues to evolve especially as an early postoperative analgesia is of paramount importance in achieving patient satisfaction and improving clinical outcomes. The goal of achieving an ideal analgesia modality which facilitates early rehabilitation, prevents knee stiffness, reduces hospital stay due to pain, and promotes good functional outcomes continues to be elusive. Multimodal analgesia has been devised to control postoperative pain and reduce opioid consumption including periarticular injection and peripheral nerve blocks. Rationale: Assess the efficacy of a triple block including Adductor canal block, superior lateral, superior medial genicular nerves block and anterior femoral cutaneous nerves block in comparison with Periarticular infiltration for pain management in patients undergoing a total knee arthroplasty. Methods: Prospective Randomized Control Trial

Conditions

Total Ankle Arthroplasty

Keywords

total knee arthroplasty; Adductor canal block; genicular nerves and femoral cutaneous nerves blocks

Outcome Measures

Primary Outcomes (1)

• End of Analgesia Time

  Time from the end of surgery until the first Numeric Rating Scale (NRS) pain score ≥ 4.

  Within the first 24 hours after surgery.

Secondary Outcomes (6)

• Total Morphine Consumption (mg)

  During the first 24 hours after surgery

• Total Tramadol Consumption (mg)

  During the first 24 hours after discharge

• Heart rate (Beat/minute)

  During the first 24 hours after surgery

• Blood pressure (mmHg)

  During the first 24 hours after surgery

• Patient Satisfaction Score

  At 24 hours after surgery

Study Arms (2)

Periarticular Infiltration Analgesia Group

ACTIVE COMPARATOR

It will be infiltrated by the surgeon before prosthesis implantation.

Procedure: Periarticular Infiltration

Triple Block Group

ACTIVE COMPARATOR

Patients will receive ultrasound-guided adductor canal, infrapatellar, medial cutaneous, and superior genicular nerve blocks.

Procedure: Ultrasound-Guided Triple Block Technique

Interventions

Periarticular Infiltration PROCEDURE

A total volume of 60 mL containing bupivacaine, ketorolac, adrenaline, and tranexamic acid will be infiltrated by the surgeon before prosthesis implantation into the posterior capsule, medial and lateral gutters, quadriceps mechanism, patellar tendon, and medial periosteum.

Periarticular Infiltration Analgesia Group

Ultrasound-Guided Triple Block Technique PROCEDURE

Patients will receive a mixture of 45 mL of 0.25% bupivacaine and 8 mg dexamethasone. A total of 15 mL will be injected into the adductor canal, 10 mL for the infrapatellar and medial cutaneous nerve blocks, and 10 mL each for the superior medial and superior lateral genicular nerve blocks.

Triple Block Group

Eligibility Criteria

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

You may qualify if:

• ASA: I \& II
• Gender: Male \& Female
• Age: 18and above
• BMI less than 40 kg/m2
• Patients are scheduled for primary unilateral total knee arthroplasty.

You may not qualify if:

• Patients with contraindications to spinal anesthesia
• Failed spinal anesthesia.
• ASA III-IV
• Body mass index (BMI)≥40,
• A known allergy or contraindication to the drugs used in this study.
• Previous knee surgery.
• Renal impairment.
• Patients who suffer from chronic neuropathic pain or on regular pain medications other than NSAIDs.

Sponsors & Collaborators

• SAMEH ELSHERBINI: lead

Study Sites (1)

Qassim University Medical City

Buraidah, Al-Qassim Region, Saudi Arabia

Location

Study Officials

• OMAR S Almisnid, Anesthesia Consultant

  Department of Anesthesia, College of Medicine, Qassim University

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: TRIPLE
• Who Masked: PARTICIPANT, CARE PROVIDER, OUTCOMES ASSESSOR
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR INVESTIGATOR
• PI Title: Associate Professor of Anesthesia

Study Record Dates

• First Submitted: July 5, 2026
• First Posted: July 15, 2026
• Study Start: January 1, 2025
• Primary Completion: April 1, 2026
• Study Completion: July 1, 2026
• Last Updated: July 15, 2026

Record last verified: 2026-07

Data Sharing

• IPD Sharing: Will not share

Locations

SA (1)