Comparing ACB+IPACK and ACB+BiFeS Block Combinations for Analgesia in Total Knee Arthroplasty

Sponsor
Hitit University
Study ID
NCT07561333
Status
Recruiting
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Conditions

  • Postoperative Pain
  • Total Knee Arthroplasty

Eligibility Criteria

Sex
ALL
Age
18 Years - 80 Years
Healthy Volunteers
Not accepted

Interventions

  • ACB+IPACK Group — PROCEDURE
    Patients receiving ultrasound-guided adductor canal block (15 mL of 0.25% bupivacaine) combined with IPACK block (25 mL of 0.25% bupivacaine) for postoperative analgesia following total knee arthroplasty under spinal anesthesia.
  • ACB+BiFeS Group — PROCEDURE
    Patients receiving ultrasound-guided adductor canal block (15 mL of 0.25% bupivacaine) combined with Biceps Femoris Short Head block (25 mL of 0.25% bupivacaine) for postoperative analgesia following total knee arthroplasty under spinal anesthesia.

Study Details

Total knee arthroplasty (TKA) is associated with severe postoperative pain that delays mobilization, prolongs hospital stay, and reduces patient satisfaction. Regional analgesia techniques have gained prominence due to their opioid-sparing effects and favorable complication profiles compared to general anesthesia. While adductor canal block (ACB) effectively manages anterior knee pain with preserved motor function, posterior knee pain remains a challenge. IPACK (Infiltration between the Popliteal Artery and Capsule of the Knee) and the Biceps Femoris Short Head (BiFeS) block are techniques targeting posterior capsule innervation without causing motor block.This prospective study aims to compare the postoperative analgesic efficacy of ultrasound-guided ACB+IPACK versus ACB+BiFeS block combinations in patients undergoing TKA under spinal anesthesia. Patients (ASA I-III, age 18-80, BMI ≤35) will be randomized into two groups (n=39 each). Primary outcomes include NRS pain scores at rest and on movement, and opioid consumption at 0, 1, 3, 6, 12, 18, and 24 hours postoperatively. Secondary outcomes include time to first mobilization, motor block incidence, quadriceps muscle strength assessment, PONV, and quality of recovery (QoR-15).

Key Dates

First listed
May 1, 2026
Start date
Oct 1, 2025
Status verified
Apr 2026
Primary completion
Oct 1, 2026
Completion
Nov 1, 2026

Study Design

Enrollment
78 participants (estimated)
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
SUPPORTIVE_CARE

Arms

  • Active Comparator: ACB+IPACK Group
    ACB+IPACK Group: Patients receiving ultrasound-guided adductor canal block (15 mL of 0.25% bupivacaine) combined with IPACK block (25 mL of 0.25% bupivacaine) for postoperative analgesia following total knee arthroplasty under spinal anesthesia.
  • Active Comparator: ACB+BiFeS Group
    ACB+BiFeS Group: Patients receiving ultrasound-guided adductor canal block (15 mL of 0.25% bupivacaine) combined with Biceps Femoris Short Head block (25 mL of 0.25% bupivacaine) for postoperative analgesia following total knee arthroplasty under spinal anesthesia.

Primary Outcome Measure

Cumulative 24-hour Opioid Consumption (Morphine Equivalent Dose) [ Time Frame: 24 hours postoperative ]

Central Contacts

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