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This prospective randomized study aims to compare the analgesic efficacy of Adductor Canal Block (ACB) and Genicular Nerve Block (GNB) groups to relieve postoperative pain in participants between ages of 18-72 undergoing arthroscopic knee surgery under spinal anesthesia. The main question it aims to answer is:
To demonstrate whether Adductor Canal Block or Genicular Nerve Block is more effective in postoperative analgesia in patients undergoing arthroscopic knee surgery based on pain scores, opioid consumption and patient satisfaction.
Arthroscopic knee surgeries cause severe pain especially with movement in the post-operative period. After surgery, the movements of the participants are severely restricted because of pain, which increases the possibility of complications and postpones post-operative knee exercises. In this study, the participants' pain status, VAS score, opioid consumption and patient satisfaction will be measured with a simple scoring system for 24 hours at predetermined time points and then compared. Both types of blocks have pain-relieving effects. This study will only investigate which one is more effective in reducing pain, and there will be no deficiency in relieving the pain of the participants.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| ACB Group | Active Comparator | Participants undergoing arthroscopic knee surgery under spinal anestesia receiving pre operative Adductor Canal Block (ACB) |
|
| Genicular Nerve Block | Active Comparator | Participants undergoing arthroscopic knee surgery under spinal anestesia receiving pre operative Genicular Nerve Block (GNB) |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Adductor Canal Block (ACB) | Procedure | Evaluation of postoperative analgesic effectiveness of ACB block in participants undergoing arthroscopic knee surgery under spinal anesthesia. |
| Measure | Description | Time Frame |
|---|---|---|
| Effectiveness on Pain Scores (NRS) | Postoperative pain assessment is performed using the Numerical Rating Scale (NRS). Participants are asked about their rest pain at Baseline 0, postoperative 1st, 2nd, 4th, 6th, 12th, and 24th hours after applying a preoperative peripheral nerve block. With this method, participants rate their pain with a precise numerical value from 0 to 10. While zero(0) represents "no pain"; Ten (10) represents the opposite end of the pain continuum (e.g., "The most intense pain imaginable," "As intense pain as possible," "Maximum pain"). | Postoperative 24 hours |
| Measure | Description | Time Frame |
|---|---|---|
| Amount of rescue analgesia administration | After the surgery all patients will be given 4 times a day Paracetamol 1 gram. Patients who still have pain (NRS 4 or higher) will be given Tramadol 1 mg/kg (maximum 400 mg Tramadol daily). Postoperative 24 hours the amount of the rescue analgesic (Tramadol) will be noted. | Postoperative 24 hours. |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| MUZAFFER GENCER | Contact | +905059436459 | dr.m.gencer07@gmail.com | |
| SİNAN ANAŞ | Contact | +905314220762 | tharkunbalrogs@gmail.com |
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Başakşehir Çam & Sakura City Hospital | Recruiting | Istanbul | Turkey (Türkiye) |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 27871547 | Background | Vora MU, Nicholas TA, Kassel CA, Grant SA. Adductor canal block for knee surgical procedures: review article. J Clin Anesth. 2016 Dec;35:295-303. doi: 10.1016/j.jclinane.2016.08.021. Epub 2016 Oct 11. | |
| 37140579 | Background | Tamam A, Guven Kose S, Kose HC, Akkaya OT. Comparison of the Effectiveness of Ultrasound-Guided Proximal, Mid, or Distal Adductor Canal Block after Knee Arthroscopy. Turk J Anaesthesiol Reanim. 2023 Apr;51(2):135-142. doi: 10.5152/TJAR.2023.22225. |
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Patients who are admitted to the orthopedic and traumatology clinic and are scheduled for arthroscopic knee surgery will be informed and monitored prior to the operation under spinal anesthesia. Preoperatively, either Adductor Canal Block (ACB) (Group A) or Genicular Nerve Block (GNB) (Group B) will be applied. Randomization will be performed using a computer-based method (http://www.randomizer.org) with a 1:1 allocation.
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| Genicular Nerve Block (GNB) | Procedure | Evaluation of postoperative analgesic effectiveness of GNB block in participants undergoing arthroscopic knee surgery under spinal anesthesia. |
|
| Postoperative Blood pressure |
Participants' blood pressure (mm/hg) will be monitored for 24 hours (Post op 1st, 2nd, 4th, 6th, 12th and 24th hours) postoperatively. |
| Postoperative 24 hours |
| Length of hospital stay | Length of hospital stay will be noted. | Postoperative 14 days |
| First Time Of Mobilisation/Exercise | First time of mobilisation/exercise will be noted. | Postoperative 24 hours |
| The Time of Rescue Analgesic | After the surgery all patients will be given 4 times a day Paracetamol 1 gram. Patients who still have pain (NRS 4 or higher) will be given Tramadol 1 mg/kg (maximum 400 mg Tramadol daily). Postoperative 24 hours the time of the rescue analgesic usage (Tramadol) will be noted. | Postoperative 24 hours |
| Postoperative heart rate | Participants' heart rate (bpm) will be monitored for 24 hours (Post op 1st, 2nd, 4th, 6th, 12th and 24th hours) postoperatively. | Postoperative 24 hours |
| Postoperative oxygen saturation levels | Participants' oxygen saturation levels (spO2 %) will be monitored for 24 hours (Post op 1st, 2nd, 4th, 6th, 12th and 24th hours) postoperatively. | Postoperative 24 hours |
| ID | Term |
|---|---|
| D010149 | Pain, Postoperative |
| ID | Term |
|---|---|
| D011183 | Postoperative Complications |
| D010335 | Pathologic Processes |
| D013568 | Pathological Conditions, Signs and Symptoms |
| D010146 | Pain |
| D009461 | Neurologic Manifestations |
| D012816 | Signs and Symptoms |
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