Using the Adductor Magnus Plain Block As an Innovative Approach for Sciatic Nerve Block for Lower Limb Surgeries.

NCT ID: NCT06852118

Last Updated: 2025-02-28

Basic Information

• Recruitment Status: ACTIVE_NOT_RECRUITING
• Clinical Phase: NA
• Total Enrollment: 60 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 2024-10-01
• Study Completion Date: 2025-06-30

Brief Summary

the goal of this clinical trial is to compare the efficacy of adductor magnus muscle plane injection as an approach for sciatic nerve block to sub-gluteal approach in combination with femoral nerve blocks as perioperative analgesia in knee surgeries.

Conditions

Adductor Magnus Plain Injection for Sciatic Nerve Block

Keywords

sciatic nerve block; Femoral nerve; Adductor magnus muscle; knee surgeries

Study Design

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

Study Groups

AMM Group: Adductor Magnus Muscle Plane approach + Femoral Nerve Blocks

Conduct the sciatic nerve block via adductor magnus plain injection. the femoral nerve block will be conducted as well

Group Type: EXPERIMENTAL

AMM Group: Adductor Magnus Muscle Plane approach + Femoral Nerve Blocks

Intervention Type: PROCEDURE

In the supine position, the femoral nerve block will be conducted using a high-frequency ultrasound probe to identify the femoral nerve just below the fascia iliaca. After proper sterilization, the needle will be advanced in-plane to inject 15 ml bupivacaine 0.5% around the nerve. After performing the femoral nerve block, the adductor magnus muscle plane block will be performed using a low-frequency ultrasound probe positioned 6 cm distal to the inguinal crease to identify the sartorius muscle, femoral artery, femoral vein, and femoral nerve on the deep side of the sartorius muscle, the probe will be slide by about 2-2.5 cm distally, where we could identify the plane between the adductor magnus and the semimembranosus muscles, and after proper sterilization, the needle will be slowly advanced until the needle tip is close to the posterior surface of the AMM, 20 mL of bupivacaine 0.5% will be injected while observing fluid distribution under the posterior surface of the AMM, Then GA.

SG Group: Sciatic nerve block by sub-gluteal approach + Femoral nerve blocks

Conduct the sciatic nerve block via sub-gluteal approach. the femoral nerve block will be conducted as well

Group Type: ACTIVE_COMPARATOR

SG Group: Sciatic nerve block by sub-gluteal approach + Femoral nerve blocks

Intervention Type: PROCEDURE

While the patient is in the supine position, the femoral nerve block will be conducted using a high-frequency ultrasound probe to identify a cross-sectional view of the femoral nerve just below the fascia iliaca. After proper sterilization, the needle will be advanced in-plane to inject 15 ml bupivacaine 0.5% around the nerve. the patient will be turned on their sides with the operative side uppermost and flexed, the sub-gluteal sciatic nerve will be identified using a low-frequency probe, and then the same needle will be advanced the in-plane to inject 20 ml bupivacaine 0.5% around the nerve., then GA will be conducted as the other group

Interventions

AMM Group: Adductor Magnus Muscle Plane approach + Femoral Nerve Blocks

In the supine position, the femoral nerve block will be conducted using a high-frequency ultrasound probe to identify the femoral nerve just below the fascia iliaca. After proper sterilization, the needle will be advanced in-plane to inject 15 ml bupivacaine 0.5% around the nerve. After performing the femoral nerve block, the adductor magnus muscle plane block will be performed using a low-frequency ultrasound probe positioned 6 cm distal to the inguinal crease to identify the sartorius muscle, femoral artery, femoral vein, and femoral nerve on the deep side of the sartorius muscle, the probe will be slide by about 2-2.5 cm distally, where we could identify the plane between the adductor magnus and the semimembranosus muscles, and after proper sterilization, the needle will be slowly advanced until the needle tip is close to the posterior surface of the AMM, 20 mL of bupivacaine 0.5% will be injected while observing fluid distribution under the posterior surface of the AMM, Then GA.

Intervention Type: PROCEDURE

SG Group: Sciatic nerve block by sub-gluteal approach + Femoral nerve blocks

While the patient is in the supine position, the femoral nerve block will be conducted using a high-frequency ultrasound probe to identify a cross-sectional view of the femoral nerve just below the fascia iliaca. After proper sterilization, the needle will be advanced in-plane to inject 15 ml bupivacaine 0.5% around the nerve. the patient will be turned on their sides with the operative side uppermost and flexed, the sub-gluteal sciatic nerve will be identified using a low-frequency probe, and then the same needle will be advanced the in-plane to inject 20 ml bupivacaine 0.5% around the nerve., then GA will be conducted as the other group

Intervention Type: PROCEDURE

Eligibility Criteria

Inclusion Criteria

• ASA (American Society of Anaesthesiologists) Physical Status I-III.
• Patients who consent to receive regional anesthesia.

Exclusion Criteria

• Patients with a history of allergy to local anesthetics.
• Pre-existing neurological deficits in the lower extremities.
• Coagulopathy or anticoagulation therapy that cannot be safely discontinued.
• Infection at the site of block injection.
• Severe obesity (BMI > 40).
• Patients with contraindications to regional anesthesia.
• peripheral neuropathy.
• Psychiatric disorders and communication difficulties.

• Minimum Eligible Age: 18 Years
• Maximum Eligible Age: 75 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: No

Sponsors

Mohammed Gaber Saad

OTHER

Sponsor Role: lead

Responsible Party

Mohammed Gaber Saad

Lecturer of anesthesia, intensive care and pain medicine

Responsibility Role: SPONSOR_INVESTIGATOR

Locations

Faculity of medicine - Al-Azhar University hospitals

Cairo, Cairo Governorate, Egypt

Countries

Egypt

References

Ben-David B, Schmalenberger K, Chelly JE. Analgesia after total knee arthroplasty: is continuous sciatic blockade needed in addition to continuous femoral blockade? Anesth Analg. 2004 Mar;98(3):747-9, table of contents. doi: 10.1213/01.ane.0000096186.89230.56.

Reference Type: BACKGROUND

PMID: 14980931 (View on PubMed)

Shanthanna H, Singh B, Guyatt G. A systematic review and meta-analysis of caudal block as compared to noncaudal regional techniques for inguinal surgeries in children. Biomed Res Int. 2014;2014:890626. doi: 10.1155/2014/890626. Epub 2014 Aug 5.

Reference Type: BACKGROUND

PMID: 25162033 (View on PubMed)

Wang L, Qu Y, Deng Y, Li J, Liu Y, Wu C. Evaluation of a New Method of Sciatic Nerve Block: A Prospective Pilot Study. J Pain Res. 2023 Jun 16;16:2091-2099. doi: 10.2147/JPR.S404489. eCollection 2023.

Reference Type: BACKGROUND

PMID: 37346396 (View on PubMed)

Other Identifiers

Anesth-.0435/2024 Med Research

Identifier Type: -

Identifier Source: org_study_id