Comparison of the Analgesic Efficacy of Adductor Canal Block Versus Adductor Canal Plus Biceps Femoris Short Head Block in Patients Undergoing Knee Arthroscopy

NCT ID: NCT07242339

Last Updated: 2026-01-20

Basic Information

• Recruitment Status: RECRUITING
• Clinical Phase: NA
• Total Enrollment: 50 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 2025-11-20
• Study Completion Date: 2026-03-30

Brief Summary

This prospective, randomized, controlled, and multicenter clinical study aims to compare the postoperative analgesic efficacy of two regional anesthesia techniques commonly used in knee arthroscopy: adductor canal block (ACB) and combined adductor canal block plus biceps femoris short head (ACB+BiFeS) block. The study will evaluate postoperative pain control, opioid consumption, adverse effects, hospital stay, and patient satisfaction. Findings will help determine the most effective and safe method for postoperative analgesia in knee arthroscopy patients.

Detailed Description

Knee arthroscopy is one of the most common orthopedic procedures and is frequently associated with significant postoperative pain. Effective multimodal analgesia is therefore essential to reduce opioid consumption, improve early mobilization, and enhance overall patient recovery. Among the regional anesthesia techniques, the adductor canal block (ACB) is well established as an effective motor-sparing block that provides analgesia to the medial and anterior aspects of the knee. However, patients often continue to experience posterolateral knee pain, which is not consistently relieved by ACB alone.

Recent anatomical and cadaveric studies have described the biceps femoris short head (BiFeS) block as a promising technique for targeting the posterolateral knee compartment. The BiFeS block involves deposition of local anesthetic between the short head of the biceps femoris muscle and the lateral femoral cortex at the supracondylar level. Preliminary findings suggest that this block may provide effective analgesia for the posterolateral knee without causing significant motor impairment.

This prospective, randomized, controlled, multicenter clinical trial is designed to evaluate whether the addition of the BiFeS block to standard ACB improves postoperative analgesia compared with ACB alone in patients undergoing knee arthroscopy under spinal anesthesia. The study will investigate pain scores at rest and during movement, total opioid consumption, side effects, rescue analgesic requirements, and quality of recovery. The dermatomal distribution of the blocks will be optionally assessed using cold testing.

By directly comparing ACB and combined ACB+BiFeS block under standardized perioperative conditions, this study seeks to generate high-quality evidence on the clinical utility of BiFeS as an adjunct technique. The results are expected to guide anesthesiologists in selecting optimal regional analgesia strategies for knee arthroscopy, with the potential to improve patient satisfaction, reduce opioid-related complications, and shorten hospitalization.

Conditions

Postoperative Pain Management

Study Design

• Allocation Method: RANDOMIZED
• Intervention Model: PARALLEL
• Primary Study Purpose: SUPPORTIVE_CARE
• Blinding Strategy: DOUBLE

Study Groups

Adductor Canal Block (ACB)

Participants will undergo ultrasound-guided adductor canal block at the end of surgery under spinal anesthesia.

Group Type: ACTIVE_COMPARATOR

Adductor Canal Block (ACB) Only

Intervention Type: PROCEDURE

Ultrasound-guided injection of 10 mL 0.25% bupivacaine into the adductor canal targeting the femoral artery region, providing motor-sparing analgesia to the medial/anterior knee.

Adductor Canal Block + Biceps Femoris Short Head Block (ACB+BiFeS)

Participants will undergo both adductor canal block and biceps femoris short head block at the end of surgery under spinal anesthesia.

Group Type: ACTIVE_COMPARATOR

biceps femoris short head block + Adductor Canal Block (ACB)

Intervention Type: PROCEDURE

Combination of adductor canal block (10 mL 0.25% bupivacaine) and biceps femoris short head block with 25 mL 0.25% bupivacaine, deposited at the interfascial plane between BiFeS muscle and lateral femoral cortex to extend analgesia to the posterolateral knee.

Interventions

Adductor Canal Block (ACB) Only

Ultrasound-guided injection of 10 mL 0.25% bupivacaine into the adductor canal targeting the femoral artery region, providing motor-sparing analgesia to the medial/anterior knee.

Intervention Type: PROCEDURE

biceps femoris short head block + Adductor Canal Block (ACB)

Combination of adductor canal block (10 mL 0.25% bupivacaine) and biceps femoris short head block with 25 mL 0.25% bupivacaine, deposited at the interfascial plane between BiFeS muscle and lateral femoral cortex to extend analgesia to the posterolateral knee.

Intervention Type: PROCEDURE

Eligibility Criteria

Inclusion Criteria

• Age ≥ 18 years
• ASA physical status I-III
• Scheduled for elective knee arthroscopy under spinal anesthesia
• Ability to provide written informed consent

Exclusion Criteria

• Coagulopathy or bleeding diathesis
• Current use of anticoagulant therapy
• Known allergy or contraindication to local anesthetics used in the study
• History of diabetes mellitus with neuropathy or other neuropathic disorders
• Contraindications to regional anesthesia techniques
• Refusal to participate

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

Sponsors

Kanuni Sultan Suleyman Training and Research Hospital

OTHER

Sponsor Role: lead

Responsible Party

Engin Ihsan Turan

principal investigator

Responsibility Role: PRINCIPAL_INVESTIGATOR

Principal Investigators

Engin ihsan Turan, Specialist

Role: PRINCIPAL_INVESTIGATOR

Health Science University İstanbul Kanuni Sultan Süleyman Education and Training Hospital

Locations

Health Science University İstanbul Kanuni Sultan Süleyman Education and Training Hospital

Istanbul, küçükçekmece, Turkey (Türkiye)

Site Status: RECRUITING

Countries

Turkey (Türkiye)

Central Contacts

Engin ihsan Turan, principal investigator

Role: CONTACT

enginihsan@hotmail.com

+905382431114

Facility Contacts

Engin ihsan turan, Principal investigator

Role: primary

enginihsan@hotmail.com

+905382431114

Other Identifiers

Bifes knee

Identifier Type: -

Identifier Source: org_study_id