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Total Knee AnthroplastyNCT07115771

Comparison of Ultrasound-Guided Lumbar ESPB and ACB for Knee Arthroplasty

A study testing Postoperative analgesia management in people with Total Knee Anthroplasty, run by Bursa City Hospital at 1 site in Turkey (Türkiye).

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

Total knee arthroplasty (TKA) is a surgical procedure frequently associated with moderate-to-severe postoperative pain. While Adductor Canal Block (ACB) has demonstrated analgesic efficacy in TKA, the Erector Spinae Plane Block (ESPB) is also being utilized as part of multimodal analgesia for postoperative pain… Read more about this study

Who is it for?
Ages 18 to 65 years
Conditions the study is for
Total Knee Anthroplasty
What is being tested?
Postoperative analgesia management
Could I receive a placebo?
No, everyone receives an active treatment
How many people
60 participants
Where
1 siteTurkey (Türkiye)
Study dates
15 Aug 2025to 15 Apr 2026
Phase
Interventional
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 to 65 years
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Inclusion Criteria Patients aged 18-65 years Patients scheduled for elective total knee arthroplasty under spinal anesthesia ASA physical status I-II Written informed consent Exclusion Criteria Refusal to participate Coagulopathy or inability to discontinue anticoagulant therapy appropriately Allergy or toxicity history to local anesthetics or opioids Infection at the injection site Severe cardiac, hepatic, or renal failure Diabetes mellitus-related neuropathy Peripheral neuropathy or motor-sensory deficit in the relevant extremity Psychiatric disease, cognitive impairment, or inability to cooperate Substance or alcohol abuse Pregnancy, suspected pregnancy, or breastfeeding Body mass index >40 kg/m² Failed spinal anesthesia or need for additional intraoperative anesthesia/analgesia

Trial locations and contacts

1 site in 1 country.

Turkey (Türkiye)1 site

  • Bursa City Hospital

    Bursa, Nilüfer, 16110

Other trials in Turkey (Türkiye)

About this study

Official title: Comparison of Ultrasound-Guided Lumbar Erector Spinae Plane Block and Adductor Canal Block on Postoperative Analgesia Management in Patients Undergoing Knee Arthroplasty

Total knee arthroplasty (TKA) is a surgical procedure frequently associated with moderate-to-severe postoperative pain. While Adductor Canal Block (ACB) has demonstrated analgesic efficacy in TKA, the Erector Spinae Plane Block (ESPB) is also being utilized as part of multimodal analgesia for postoperative pain management in lower extremity surgeries. Currently, there is a gap in the literature as no studies have directly compared the efficacy of ACB and ESPB for pain management following TKA. The primary objective of this study is to compare the efficacy of these two analgesic methods in the context of postoperative analgesia management after total knee arthroplasty.

Read the detailed description

In our clinic, various regional blocks are applied for analgesia or anesthesia purposes in many surgeries, including knee surgery. For knee surgery, adductor canal block, lumbar epidural analgesia, genicular block, erector spinae plane block, and iPACK block can be used. In our clinic, erector spinae plane block and adductor canal block are routinely applied to knee surgery patients. In our study, we aimed to contribute to the literature by comparing patient satisfaction surveys and pain follow-up in patients undergoing knee arthroplasty who received adductor canal block versus lumbosacral erector spinae plane block, both applied with PROSPECT protocols for postoperative analgesia.

Being tested
Postoperative analgesia management
Keywords
Postoperative Analgesia, adductor canal block, erector spinae plane block, Total Knee Anthroplasty

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Postoperative analgesia managementOther

    After identifying the L5 transverse process with ultrasound guidance, an 80 mm block needle (Stimuplex Ultra®, Braun, Melsungen, Germany) will be advanced in a cranio-caudal direction until the tip contacts the L5 transverse process. Following hydrodissection, 30 ml of 0.25% bupivacaine local anesthetic solution containing epinephrine 1:200,000 (5 mcg/ml; 150 mcg in total) will be administered.

  • Postoperative analgesia managementOther

    After identifying the adductor canal with a high-frequency linear US probe (GE ML6-15-D Matrix Linear), 30 ml of 0.25% bupivacaine local anesthetic solution containing epinephrine 1:200,000 (5 mcg/ml; 150 mcg in total) will be administered into the adductor canal using an 80 mm block needle (Stimuplex Ultra®, Braun, Melsungen, Germany).

Study groups in NCT07115771
Study groupRoleWhat they receive
Adductor canal blockActive comparatorPatients will receive an adductor canal block preoperatively.
Receives: Other: Postoperative analgesia management
Erector spinae plane blockActive comparatorPatients will receive a lumbosacral erector spinae plane block in the preoperative period.
Receives: Other: Postoperative analgesia management

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. opioid consumption

    Tramadol will be prepared as 5mg/ml and patient-controlled analgesia will be administered without basal infusion, with a locking time of 20 minutes and a bolus dose of 10mg.

    Measured: 0-48 hours postoperatively

Secondary outcomes (3)

  1. Postoperative pain scores (Numerical rating scale) (0-meaning "no pain" to 10-meaning "worst pain imaginable")

    Postoperative 48-hour period. Patients' pain scores at rest will be questioned at 0, 1, 2, 4, 8, 12, 24 and 48 hours.

    Measured: The NRS scores of the patients will be evaluated at the postoperative 0, 1, 2, 4, 8, 12, 24 and 48 hours.

  2. Quality of recovery (Quality of Recovery-15, QoR-15 score)

    Researchers will use the Turkish version of the Quality Improvement Survey/QoR-15. PART A: Participants will be asked by researchers how they felt in the last 24 hours.(0 to 10, where: 0 = none of the time [poor] and 10 = all of the time [excellent]) 1. Able to breathe easily 2. Been able to enjoy food 3. Feeling rested 4. Have had a good sleep 5. Able to look after personal toilet and hygiene unaided 6. Able to communicate with 7. Getting support from hospital doctors and nurses 8. Able to return to work or usual home activities 9. Feeling comfortable and in control 10. Having a feeling of general well-being PART B Participants will be asked by the researchers whether they have experienced any of the following in the last 24 hours. (10 to 0, where: 10 = none of the time [excellent] and 0 = all of the time [poor]) 11. Moderate pain 12. Severe pain 13. Nausea or vomiting 14. Feeling worried or anxious 15. Feeling sad or depressed

    Measured: The quality of recovery will be evaluated out of a total of 150 points according to the QoR-15 test to be applied at the portoperative 48th hour.

  3. Determine the time to first postoperative mobilization (The Timed Up and Go - TUG test):

    Place a chair in a location where walking can be observed. The area should be free of obstacles and interruptions. Measure a distance of 3 meters and draw a line on the floor at this distance. Use colored tape if available (to be clearly visible from the floor). Seat the patient in a chair, with access to their usual walking aid if applicable. Ask the patient to "start" and begin the timer. The patient stands up, walks past the 3-meter mark, turns, then walks back to the chair and sits down again. Record the time taken to complete the entire maneuver. The test is performed before the block (TUG1) and 30 minutes after the block, before spinal anesthesia (TUG2); the difference (TUG2 - TUG1) reflects the acute motor effect of the block.

    Measured: Before the block and 30 minutes after the block, before spinal anesthesia

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted11 Aug 2025
  2. Study start15 Aug 2025
  3. Primary completion15 Apr 2026
  4. Study completion15 Apr 2026

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
Double blind
Who is masked
Participant, Outcomes assessor
Enrolment
60 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT07115771
Sponsor's protocol ID
Bursa Şehir Hastanesi 12
Status last verified
May 2026
First submitted
4 Aug 2025
Last updated
2 Oct 2026
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No: Individual participant data (IPD) will not be shared

Publications

  • Tran J, Chan VWS, Peng PWH, Agur AMR. Evaluation of the proximal adductor canal block injectate spread: a cadaveric study. Reg Anesth Pain Med. 2019 Dec 25:rapm-2019-101091. doi: 10.1136/rapm-2019-101091. Online ahead of print.

    PubMed 31879373

  • Tao Y, Zheng SQ, Xu T, Wang G, Wang Y, Wu AS, Yue Y. Median effective volume of ropivacaine 0.5% for ultrasound-guided adductor canal block. J Int Med Res. 2018 Oct;46(10):4207-4213. doi: 10.1177/0300060518791685. Epub 2018 Aug 20.

    PubMed 30124351

  • Gupta A, Kaur J, Kumar R. Unilateral sacral erector spinae plane block for lower limb surgery in children. Anaesth Rep. 2022 Dec 14;10(2):e12199. doi: 10.1002/anr3.12199. eCollection 2022 Jul-Dec.

    PubMed 36530341

  • Browne W, Nair BKR. The Timed Up and Go test. Med J Aust. 2019 Jan;210(1):13-14.e1. doi: 10.5694/mja2.12045. Epub 2018 Dec 28. No abstract available.

    PubMed 30636313

  • Diwan S, Nair A. Lumbar erector spinae plane block obtunding knee and ankle reflexes. Saudi J Anaesth. 2021 Apr-Jun;15(2):222-224. doi: 10.4103/sja.SJA_79_20. Epub 2021 Apr 1.

    PubMed 34188648

  • Kaya C, Dost B, Tulgar S. Sacral Erector Spinae Plane Block Provides Surgical Anesthesia in Ambulatory Anorectal Surgery: Two Case Reports. Cureus. 2021 Jan 9;13(1):e12598. doi: 10.7759/cureus.12598.

    PubMed 33585088

  • Selvi O, Azizoglu M, Temel G, Tulgar S, Chitneni A, Cinar EN, Ozer Z, Gurkan Y. Translation and Validation of the Turkish Version of the Quality of Postoperative Recovery Score QoR-15: A Multi-Centred Cohort Study. Turk J Anaesthesiol Reanim. 2022 Dec;50(6):443-448. doi: 10.5152/TJAR.2022.21417.

    PubMed 36511494

Questions about this trial

What is this clinical trial studying?

A study testing Postoperative analgesia management in people with Total Knee Anthroplasty, run by Bursa City Hospital at 1 site in Turkey (Türkiye).

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 2 Oct 2026. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in Turkey (Türkiye). Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

opioid consumption (time frame: 0-48 hours postoperatively). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT07115771, which also lists 7 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 2 Oct 2026.

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