Comparison of Fasia Iliac Compartment Block and 4in1 Block

NCT ID: NCT06436105

Last Updated: 2025-06-29

Basic Information

• Recruitment Status: COMPLETED
• Clinical Phase: NA
• Total Enrollment: 60 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 2024-05-30
• Study Completion Date: 2024-07-08

Brief Summary

Patients who will undergo elective total knee arthroplasty surgery under spinal anesthesia will be included in the study according to the postoperative analgesia method applied: Group Control, Group FICB and Group 4in1. Peripheral nerve block will be performed with 30 ml %0.25 bupivacaine for Group FICB and Group 4 in 1 patients. Peripheral nerve block will not be performed on Group Control patients. Patient-controlled analgesia will be given to all three groups in the postoperative period. PCA is a pain palliation method routinely used in all patients postoperatively. NRS score, PCA tramadol consumption, PCA demand, need for additional analgesia, patient satisfaction, nausea and vomiting will be monitored 24 hours postoperatively. The aim of this study is to compare the perioperative analgesic effectiveness of patients who underwent fascia iliaca compartment block and 4 in 1 block in total knee arthroplasty surgery, with each other and with the control group.

Detailed Description

Total knee arthroplasty is a surgical procedure performed mostly on patients with osteoarthritis who have failed traditional conservative treatment. Increasing knee osteoarthritis due to reasons such as life expectancy and body mass index causes this surgical procedure to be performed more frequently. The knee joint which is innervated by the femoral, obturator, sciatic nerves and their branches has a complicated innervation and the pain following total knee arthrplasty is quite severe. It is aimed to provide effective analgesia by blocking these nerves or terminal branches with various peripheral nerve blockade methods under USG guidance. In recent years, interest in studies aiming to block these nerves with a single injection has been increasing. 4 in 1 block is a new technique applied from a single injection point to block the saphenous, obturator, sciatic and vastus medialis nerves that innervate the knee joint. Fascia iliaca compartment block is a reliable technique applied from a single injection point to block the femoral, lateral femoral cutaneous and obturator nerves behind the fascia iliaca.

Patients who will undergo elective total knee arthroplasty surgery under spinal anesthesia will be included in the study according to the postoperative analgesia method applied: Group Control, Group FICB and Group 4in1. Peripheral nerve block will be performed with 30 ml %0.25 bupivacaine for Group FICB and Group 4 in 1 patients. Peripheral nerve block will not be performed on Group Control patients. Patient-controlled analgesia will be given to all three groups in the postoperative period. PCA is a pain palliation method routinely used in all patients postoperatively. NRS score, PCA tramadol consumption, PCA demand, need for additional analgesia, patient satisfaction, nausea and vomiting will be monitored 24 hours postoperatively. The aim of this study is to compare the perioperative analgesic effectiveness of patients who underwent fascia iliaca compartment block and 4 in 1 block in total knee arthroplasty surgery, with each other and with the control group.

Conditions

Pain, Postoperative

Study Design

• Allocation Method: RANDOMIZED
• Intervention Model: PARALLEL
• Primary Study Purpose: OTHER
• Blinding Strategy: SINGLE

Study Groups

Group Control

Peripheral nerve block will not be performed on Group Control patients.

Group Type: OTHER

Control

Intervention Type: OTHER

Peripheral nerve block will not be performed on Group Control patients.

Group FICB

FICB will be performed with 30 ml %0.25 bupivacaine for Group FICB patients.

Group Type: OTHER

FICB

Intervention Type: OTHER

FICB is applied to the patients after spinal anesthesia.

Group 4 IN 1

4 in 1 block will be performed with 30 ml %0.25 bupivacaine for Group 4 IN 1 patients.

Group Type: OTHER

4 in 1 block

Intervention Type: OTHER

4 in 1 block is applied to the patients after spinal anesthesia.

Interventions

FICB

FICB is applied to the patients after spinal anesthesia.

Intervention Type: OTHER

4 in 1 block

4 in 1 block is applied to the patients after spinal anesthesia.

Intervention Type: OTHER

Control

Peripheral nerve block will not be performed on Group Control patients.

Intervention Type: OTHER

Eligibility Criteria

Inclusion Criteria

• With informed consent
• Elective total knee arthroplasty with spinal anesthesia
• Oriented and cooperative
• ASA Classification I-II-III
• 18-85 years old

Exclusion Criteria

• Anticoagulant medication
• Coagulopathy
• Infection at the site of peripheral nerve block application
• Allergy to local anesthetics
• Pregnant or suspected pregnancy

• Minimum Eligible Age: 18 Years
• Maximum Eligible Age: 85 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: No

Sponsors

Diskapi Yildirim Beyazit Education and Research Hospital

OTHER_GOV

Sponsor Role: lead

Responsible Party

Savas Altinsoy

Principal Investigator

Responsibility Role: PRINCIPAL_INVESTIGATOR

Locations

Department of Anesthesiology and Reanimation, University of Health Sciences, Diskapi Yıldırım Beyazit Training and Research Hospital

Ankara, , Turkey (Türkiye)

Countries

Turkey (Türkiye)

References

Roy R, Agarwal G, Pradhan C, Kuanardr D, Mallick DJ. Ultrasound guided 4 in 1 block - a newer, single injection technique for complete postoperative analgesia for knee and below knee surgeries. Anaesthesia, Pain & Intensive Care. 2018;22(1):87-92.

Reference Type: BACKGROUND

Kanadli H, Dogru S, Karaman T, Karaman S, Tapar H, Sahin A, Asci M, Kanadli KA, Suren M. Comparison of the efficacy of femoral nerve block and fascia iliaca compartment block in patients with total knee replacement. Minerva Anestesiol. 2018 Oct;84(10):1134-1141. doi: 10.23736/S0375-9393.18.12062-1. Epub 2018 Jan 16.

Reference Type: RESULT

PMID: 29338141 (View on PubMed)

Other Identifiers

İsa Öteleş

Identifier Type: -

Identifier Source: org_study_id