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Biceps Femoris Short Head (BiFeS) Block and Adductor Canal Block for Postoperative Analgesia Following Total Knee Arthroplasty

ConditionsPostoperative Pain Following Knee ArthroplastyTotal Knee Arthroplasty
Trial statusRecruiting
Trial phaseNot applicable
Trial typeInterventional
Biological sexAll
Age18-80
SponsorÖmer Kayar

About this trial

This prospective randomized controlled study aims to evaluate the effect of ultrasound-guided Biceps Femoris Short Head (BiFeS) block combined with adductor canal block on postoperative opioid consumption and pain control in patients undergoing elective total knee arthroplasty under spinal anesthesia.

A total of 60 patients aged 18-80 years with ASA physical status I-III scheduled for unilateral elective total knee arthroplasty will be randomized into two groups. The intervention group will receive spinal anesthesia followed by BiFeS block and adductor canal block before surgery, in addition to standard multimodal analgesia and postoperative morphine patient-controlled analgesia (PCA). The control group will receive spinal anesthesia and standard multimodal analgesia with postoperative morphine PCA without peripheral nerve block.

The primary outcome is total morphine consumption during the first 24 postoperative hours. Secondary outcomes include postoperative pain scores assessed by Numeric Rating Scale (NRS), time to first analgesic requirement, time to first foot movement, and Quality of Recovery-15 (QoR-15) scores.

Eligibility criteria

This trial accepts healthy volunteers

Qualifiers

Patients aged 18 and older

ASA I-III

Patients scheduled for elective unilateral knee replacement

Eligibility for and consent to spinal anesthesia

Disqualifiers

History of allergy or anaphylaxis to local anesthetics, animal gelatin, or chlorhexidine

Bleeding diathesis/inability to discontinue anticoagulants

Infection (at the injection site/sepsis)

Neurological disorders or cognitive impairment affecting pain perception

Trial design

Design model

Parallel

Treatments tested in this trial

  • Procedure: Biceps Femoris Short Head Block

    Procedure/Surgery

    Patients will receive spinal anesthesia followed by ultrasound-guided Biceps Femoris Short Head (BiFeS) block using 25 mL of 0.25% bupivacaine and adductor canal block using 15 mL of 0.25% bupivacaine before surgery. Standard multimodal analgesia will be provided using intravenous paracetamol and dexketoprofen, along with postoperative patient-controlled analgesia with morphine for 24 hours.

  • Procedure: Spinal Anesthesia

    Procedure/Surgery

    Patients will receive spinal anesthesia without peripheral nerve block. Standard multimodal analgesia will be provided using intravenous paracetamol and dexketoprofen, along with postoperative patient-controlled analgesia with morphine for 24 hours.

Treatment groups

60 Participants
are divided into 2 treatment groups
Group A: Block GroupExperimental treatment 1 intervention
Group B: Multimodal Analgesia GroupActive comparator 1 intervention

Trial outcomes

Primary outcomes

1

Total Morphine Consumption in 24 Hours

Total cumulative morphine consumption measured from patient-controlled analgesia device during the first 24 postoperative hours.

Time frame
Within the first 24 hours after surgery

Secondary outcomes

1

Numeric Rating Scale (NRS) Pain Scores

Pain intensity measured using NRS at rest (0-10 scale).

Time frame
Postoperative 1, 6, 12, and 24 hours
2

Time to First Analgesic Requirement

Time from end of surgery to first patient-reported pain requiring analgesic medication.

Time frame
24 hours
3

Time to First Foot Movement

Time from completion of surgery to first active foot movement.

Time frame
24 hours
4

QoR-15 Score

Postoperative quality of recovery will be assessed using the validated 15-item Quality of Recovery questionnaire (QoR-15), which evaluates patient well-being, physical comfort, emotional state, psychological support, and pain. Total scores range from 0 to 150, with higher scores indicating better postoperative recovery.

Time frame
24 hours postoperatively

Other outcomes

Sponsors and contacts

Click on the lead sponsor to view all of their trials.

Ömer Kayar

Lead sponsor

Kayseri City Hospital

Sponsor institution

Source ClinicalTrials.gov
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