Anterior Cruciate Ligament Injuries, Postoperative Pain
Conditions
Keywords
Adductor Canal Block, iPACK Block, Femoral Triangle Block, Knee Arthroscopy
Brief summary
This prospective, comparative study aims to evaluate the postoperative analgesic efficacy of ultrasound-guided Adductor Canal Block (ACB) combined with iPACK block versus Femoral Triangle Block (FTB) combined with selective tibial nerve block and obturator nerve block in patients undergoing arthroscopic anterior cruciate ligament (ACL) reconstruction. The primary objective is to determine which regional anesthesia regimen provides superior pain relief at rest and during movement. The secondary objectives include assessing morphine consumption, motor blockade using the Bromage score, patient satisfaction, and potential adverse effects of these anesthesia techniques.
Interventions
PROCEDUREUltrasound-guided Adductor Canal Block (ACB)
Ultrasound-guided administration of 10 mL levobupivacaine 0.2% into the adductor canal space to provide postoperative analgesia
PROCEDUREUltrasound-guided iPACK block
Ultrasound-guided administration of 15 mL levobupivacaine 0.2% into the space between the popliteal artery and the posterior capsule of the knee to provide posterior knee analgesia.
PROCEDUREUltrasound-guided Femoral Triangle Block (FTB)
Ultrasound-guided administration of 10 mL levobupivacaine 0.2% at the distal apex of the femoral triangle to provide anterior and medial knee analgesia
PROCEDUREUltrasound-guided Selective Tibial Nerve Block
Ultrasound-guided administration of 5 mL levobupivacaine 0.2% around the tibial nerve in the popliteal fossa
PROCEDUREUltrasound-guided Obturator Nerve Block
Ultrasound-guided administration of 10 mL levobupivacaine 0.2% targeting the anterior and posterior branches of the obturator nerve within the fascial planes between the adductor muscles.
Sponsors
Da Nang Hospital
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
TRIPLE (Subject, Caregiver, Investigator)
Eligibility
Sex/Gender
ALL
Age
16 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Age 16 years and older * Patients undergoing elective arthroscopic anterior cruciate ligament (ACL) reconstruction * ASA physical status I-II * Indicated for spinal anesthesia * Provided informed consent
Exclusion criteria
* Infection at the injection site * Spinal cord or lower limb nerve injury * Contraindications to regional anesthesia (Levobupivacaine) * Known allergy to Paracetamol or Diclofenac * Coagulopathy
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Visual Analog Scale (VAS) for Pain at Rest and Movement | Within the first 24 hours postoperatively | Evaluating pain scores using the Visual Analog Scale (VAS) at rest and during knee flexion at 0, 1, 3, 6, 9, 12, 18, and 24 hours postoperatively |
Secondary
| Measure | Time frame |
|---|---|
| Total Rescue Morphine Consumption | Within the first 24 hours postoperatively |
| Motor Blockade Assessment using Bromage Score | Within the first 24 hours postoperatively |
| Patient Satisfaction Score | 24 hours postoperatively |
Contacts
CONTACTNhan Trong Phan, MD. MSc
CONTACTTrong Nhan Phan
PRINCIPAL_INVESTIGATORNhan T Phan, MD. MSc
Da Nang Hospital
Outcome results
None listed