Targeted Nerve Injection to the Knee (Nerve to Vastus Medialis): Comparing Two Adductor Canal Block Approaches

Trial statusNot yet recruiting
Trial phasePhase 4
Trial typeInterventional
Biological sexAll
Age18+
SponsorDuke University

About this trial

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.

Eligibility criteria

This trial accepts healthy volunteers

Qualifiers

Age ≥18 years

Able to provide written informed consent

Able and willing to comply with study procedures and ~6-hour visit

American Society of Anesthesiologists (ASA) Physical Status 1 or 2

Disqualifiers

BMI >35 kg/m²

Use of analgesics within 24 hours before the procedure

History of thigh trauma or surgery

Pregnant or planning pregnancy

Trial design

Design model

Crossover

Treatments tested in this trial

  • Traditional adductor canal block

    Procedure/Surgery

    Ultrasound-guided injection adjacent to the saphenous nerve; 20 mL of 2% chloroprocaine.

  • NVM (nerve to vastus medialis) targeted adductor canal block

    Procedure/Surgery

    Ultrasound-guided injection; 10 mL 2% chloroprocaine at the NVM (confirmed by nerve stimulation), plus 10 mL at the saphenous nerve.

  • Chloroprocaine Injection

    Drug

    2% chloroprocaine

Treatment groups

25 Participants
are divided into 2 treatment groups
Group A: Traditional adductor canal blockActive comparator 2 interventions
Group B: NVM (nerve to vastus medialis) targeted adductor canal blockExperimental treatment 2 interventions

Trial outcomes

Primary outcomes

1

Quadriceps strength as measured by load cell dynamometer

Load cell dynamometers are highly accurate portable electronic devices used to measure isometric muscle strength.

Time frame
Day 1

Secondary outcomes

1

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.

Time frame
Day 1

Other outcomes

Locations

This trial has no locations.

Sponsors and contacts

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