Comparison of Ultrasound-Guided Lumbar ESPB and ACB for Knee Arthroplasty

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

RECRUITING

Clinical Phase

NA

Total Enrollment

60 participants

Study Classification

INTERVENTIONAL

Study Start Date

2025-08-15

Study Completion Date

2026-05-15

Brief Summary

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Total knee arthroplasty (TKA) is a surgical procedure frequently associated with moderate-to-severe postoperative pain. While Adductor Canal Block (ACB) has demonstrated analgesic efficacy in TKA, the Erector Spinae Plane Block (ESPB) is also being utilized as part of multimodal analgesia for postoperative pain management in lower extremity surgeries. Currently, there is a gap in the literature as no studies have directly compared the efficacy of ACB and ESPB for pain management following TKA. The primary objective of this study is to compare the efficacy of these two analgesic methods in the context of postoperative analgesia management after total knee arthroplasty.

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Detailed Description

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In our clinic, various regional blocks are applied for analgesia or anesthesia purposes in many surgeries, including knee surgery. For knee surgery, adductor canal block, lumbar epidural analgesia, genicular block, erector spinae plane block, and iPACK block can be used. In our clinic, erector spinae plane block and adductor canal block are routinely applied to knee surgery patients. In our study, we aimed to contribute to the literature by comparing patient satisfaction surveys and pain follow-up in patients undergoing knee arthroplasty who received adductor canal block versus lumbosacral erector spinae plane block, both applied with PROSPECT protocols for postoperative analgesia.

Conditions

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Total Knee Anthroplasty

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

DOUBLE

Participants Outcome Assessors

he patient and the outcomes assessor who performs postoperative pain evaluation will not know the group

Study Groups

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Adductor canal block

Patients will receive an adductor canal block preoperatively.

Group Type ACTIVE_COMPARATOR

Postoperative analgesia management

Intervention Type OTHER

After identifying the adductor canal with a high-frequency linear US probe (GE ML6-15-D Matrix Linear), 30 ml of 0.25% bupivacaine local anesthetic solution containing 7.5 mcg of epinephrine (1:200,000) will be administered into the adductor canal using an 80 mm block needle (Stimuplex Ultra®, Braun, Melsungen, Germany).

Erector spinae plane block

Patients will receive a lumbosacral erector spinae plane block in the preoperative period.

Group Type ACTIVE_COMPARATOR

Postoperative analgesia management

Intervention Type OTHER

After determining the L5-S1 level with ultrasound guidance, an 80 mm block needle (Stimuplex Ultra®, Braun, Melsungen, Germany) will be advanced in a cranio-caudal direction. Following hydrodissection, 30 ml of 0.25% bupivacaine local anesthetic solution containing 7.5 mcg of epinephrine (1:200,000) will be administered.

Interventions

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Postoperative analgesia management

After determining the L5-S1 level with ultrasound guidance, an 80 mm block needle (Stimuplex Ultra®, Braun, Melsungen, Germany) will be advanced in a cranio-caudal direction. Following hydrodissection, 30 ml of 0.25% bupivacaine local anesthetic solution containing 7.5 mcg of epinephrine (1:200,000) will be administered.

Intervention Type OTHER

Postoperative analgesia management

After identifying the adductor canal with a high-frequency linear US probe (GE ML6-15-D Matrix Linear), 30 ml of 0.25% bupivacaine local anesthetic solution containing 7.5 mcg of epinephrine (1:200,000) will be administered into the adductor canal using an 80 mm block needle (Stimuplex Ultra®, Braun, Melsungen, Germany).

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

* patients who underwent total knee arthroplasty surgery
* ASA I-II patients

Exclusion Criteria

* Patient refusal to participate in the study
* Patients with coagulopathy
* Patients history with local anesthetic allergy or toxicity
* Patients with liver and kidney failure
* Mentally disabled patients
* Presence of infection at the injection site
* Pregnant, suspected pregnant, or breastfeeding mothers

Minimum Eligible Age

18 Years

Maximum Eligible Age

65 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No