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Meniscopathy surgeries are commonly associated with moderate postoperative pain, particularly during early mobilization and rehabilitation. Inadequate postoperative analgesia may negatively affect functional recovery, delay ambulation, increase opioid consumption, and contribute to opioid-related adverse effects. Therefore, effective multimodal analgesic strategies are of considerable importance in patients undergoing arthroscopic knee procedures.
Adductor canal block (ACB) is a widely used regional anesthesia technique that provides effective analgesia while largely preserving quadriceps muscle strength. However, its limited effect on posterior knee capsule innervation may result in insufficient control of posterior knee pain. Recently, the biceps femoris short head (BiFeS) block has been described as a novel motor-sparing fascial plane block targeting the posterolateral knee capsule and may provide additional analgesic benefit when combined with ACB.
In this study, it was aimed to compare the postoperative analgesic efficacy of adductor canal block alone and adductor canal block combined with BiFeS block in patients undergoing surgery for meniscopathy.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Adductor Canal Block Group | Active Comparator | After the linear ultrasound probe is placed transversely over the mid-thigh on the side of surgery, the sartorius muscle, femoral artery, vastus medialis muscle, and adductor canal will be identified. The probe will be adjusted to obtain an optimal short-axis view of the femoral artery beneath the sartorius muscle. A block needle will then be advanced using an in-plane technique toward the adductor canal. After negative aspiration, 10 ml of 0.25% bupivacaine will be injected into the fascial plane adjacent to the femoral artery within the adductor canal. Proper spread of the local anesthetic around the femoral artery and beneath the sartorius muscle will be confirmed by ultrasound imaging. |
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| Adductor Canal Block + BiFeS (Biceps Femoris Short Head) Block Group | Active Comparator | First, 10 ml of 0.25% bupivacaine will be injected into the adductor canal, and proper spread of the local anesthetic around the femoral artery and beneath the sartorius muscle will be confirmed by ultrasound imaging. Subsequently, the biceps femoris short head block will be performed under ultrasound guidance on the same side. The ultrasound probe will be positioned to identify the short head of the biceps femoris muscle and the lateral femoral cortex at the distal thigh/supracondylar region. A block needle will be advanced using an in-plane technique toward the fascial plane between the short head of the biceps femoris muscle and the lateral femoral cortex. After negative aspiration, 20 ml of 0.25% bupivacaine will be injected into this plane. Adequate spread of the local anesthetic along the interface between the biceps femoris short head and the femur will be confirmed by ultrasound imaging. |
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| Control Group | Active Comparator | Participants in the control group will not receive any regional block intervention. |
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Adductor Canal Block Group | Procedure | Adductor canal block will be performed on the patients using 10 ml of 0.25% bupivacaine under ultrasound guidance. Additionally, in the postoperative period a paracetamol dose of 1 g every 8 hours and a dexketoprofen dose of 50 mg twice daily were administered iv for multimodal analgesia. |
| Measure | Description | Time Frame |
|---|---|---|
| Pain Scores | Pain will be assessed at rest and while coughing using the visual analog scale on a scale from 0 (no pain) to 100 (worst pain). Pain assessment will be done at 0st, 1st, 2nd,4th, 12th, and 24th hours after surgery. | On the operation day |
| Measure | Description | Time Frame |
|---|---|---|
| Total Postoperative Morphine Consumption During the First 24 Hours After Surgery | Total Postoperative Morphine Consumption During the First 24 Hours After Surgery | On the operation day |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Atakan Sezgi | Contact | 00905323327000 | kansezgi@gmail.com | |
| Musa Zengin | Contact | 00905307716235 | musazengin@gmail.com |
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Ankara Etlik City Hospital | Recruiting | Ankara | Turkey (Türkiye) |
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| Adductor Canal Block + BiFeS (Biceps Femoris Short Head) Block Group | Procedure | In the adductor canal block + BiFeS block group, adductor canal block will be performed using 10 ml of 0.25% bupivacaine, followed by BiFeS block using 20 ml of 0.25% bupivacaine under ultrasound guidance, with a total local anesthetic volume of 30 ml. Additionally, in the postoperative period a paracetamol dose of 1 g every 8 hours and a dexketoprofen dose of 50 mg twice daily were administered iv for multimodal analgesia. |
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| Control Group | Procedure | In the postoperative period a paracetamol dose of 1 g every 8 hours and a dexketoprofen dose of 50 mg twice daily were administered iv for multimodal analgesia. |
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| ID | Term |
|---|---|
| D000377 | Agnosia |
| ID | Term |
|---|---|
| D010468 | Perceptual Disorders |
| D019954 | Neurobehavioral Manifestations |
| D009461 | Neurologic Manifestations |
| D009422 | Nervous System Diseases |
| D012816 | Signs and Symptoms |
| D013568 | Pathological Conditions, Signs and Symptoms |
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| ID | Term |
|---|---|
| D035061 | Control Groups |
| ID | Term |
|---|---|
| D015340 | Epidemiologic Research Design |
| D004812 | Epidemiologic Methods |
| D008919 | Investigative Techniques |
| D012107 | Research Design |
| D008722 | Methods |
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