Anterior Cutaneus Nerve and Distal Adductor Canal Block With USG for Total Knee Replacement Analgesia

Contribution of Anterior Femoral Cutaneous Nerve Block to Postoperative Analgesia for Total Knee Replacement

This prospective clinical study was approved by the institutional ethics committee on September 27, 2023, and patient enrollment started in October 2023. the study aimed to evaluate the contribution of anterior femoral cutaneus nerve block to postoperative analgesia in total knee artroplasty.

The goal of this clinical trial is to compare analhesia effects of adductor canal blockade versus distal adductur canal blockade added anterior cutaneus nerve block in total knee arthroplasty.

The main questions it aims to answer are:

• question 1: does distal adductor canal blockade + anterior cutaneus nerve blokade superior analgesia then adductor canal block for undergoing TKP?
• question 2: does distal adductor canal blockade + anterior cutaneus nerve blokade decrease drain place pain on anterolateral face of knee?

Patients with American Society of Anesthesiologists classification status I-III scheduled for elective primary TKA using standard spinal anesthesia enroll for this trial. After surgery patient divided two groups: 1- adductor canal blockade 2- distal adductor canal blockade + anterior femoral cutaneus nerve blockade. At postoperative 3th, 10th, 24th hour VAS (visuel analouge scale), VAS move, incision plase pain-for top and down of patella, drain place pain, motor strenght for femoral nerve and siyatic nerve, first analjesic requirement time, opioid consumption, total analcesic requirement will be recorded.

Inclusion Criteria:

• Total knee artroplasty
• Spinal anesthesia
• ASA 1-3

Exclusion Criteria:

• Bupivacaine allergy
• Coagulopathy
• Infection on injection site