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This randomized, double-blinded volunteer study compares two ways of performing the adductor canal (AC) nerve block at the mid-thigh to see which approach more reliably numbs the anteromedial knee. One approach is the traditional AC block placed near the saphenous nerve; the other separately targets the nerve to vastus medialis (NVM) in addition to the saphenous nerve. Healthy adult participants receive both blocks in one visit (one on each leg), with the order randomized. The primary outcome is change in quadriceps strength (a proxy for vastus medialis anesthesia) measured by load-cell dynamometry. Secondary outcomes include cutaneous sensory mapping (pinprick and cold) and the percentage of a standardized, marked knee-incision line covered by sensory block. The study uses ultrasound guidance and a standard dose of chloroprocaine, with routine monitoring to minimize risks.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Traditional adductor canal block | Active Comparator | 20 mL of 2% chloroprocaine deposited adjacent to the saphenous nerve under ultrasound guidance. |
|
| NVM (nerve to vastus medialis) targeted adductor canal block | Experimental | 10 mL of 2% chloroprocaine by the NVM (confirmed with nerve stimulation), plus 10 mL by the saphenous nerve (total 20 mL), under ultrasound guidance. |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Traditional adductor canal block | Procedure | Ultrasound-guided injection adjacent to the saphenous nerve; 20 mL of 2% chloroprocaine. |
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| Measure | Description | Time Frame |
|---|---|---|
| Quadriceps strength as measured by load cell dynamometer | Load cell dynamometers are highly accurate portable electronic devices used to measure isometric muscle strength. | Day 1 |
| Measure | Description | Time Frame |
|---|---|---|
| Percentage of hypothetical incision covered | An unblinded anesthesiologist will mark the mock total knee arthroplasty and the length of the hypothetical incision that has diminished sensation to pinprick will be determined. | Day 1 |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Ashley Burke | Contact | (919) 681-2849 | ashley.burke@duke.edu |
| Name | Affiliation | Role |
|---|---|---|
| Brian Mendelson | Duke University | Principal Investigator |
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| NVM (nerve to vastus medialis) targeted adductor canal block | Procedure | Ultrasound-guided injection; 10 mL 2% chloroprocaine at the NVM (confirmed by nerve stimulation), plus 10 mL at the saphenous nerve. |
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| Chloroprocaine Injection | Drug | 2% chloroprocaine |
|
| ID | Term |
|---|---|
| C004616 | chloroprocaine |
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