Postoperative Pain Managementbifes kneeNCT07242339
Comparison of the Analgesic Efficacy of Adductor Canal Block Versus Adductor Canal Plus Biceps Femoris Short Head Block in Patients Undergoing Knee Arthroscopy
A study testing Adductor Canal Block (ACB) Only and biceps femoris short head block + Adductor Canal Block (ACB) in people with Postoperative Pain Management, run by Kanuni Sultan Suleyman Training and Research Hospital at 1 site in Turkey (Türkiye).
Trial summary
This prospective, randomized, controlled, and multicenter clinical study aims to compare the postoperative analgesic efficacy of two regional anesthesia techniques commonly used in knee arthroscopy: adductor canal block (ACB) and combined adductor canal block plus biceps femoris short head (ACB+BiFeS) block. Read more about this study
- Who is it for?
- Ages 18 years and older
- Conditions the study is for
- Postoperative Pain Management
- What is being tested?
- Adductor Canal Block (ACB) Only and biceps femoris short head block + Adductor Canal Block (ACB)
- Type of treatment
- Injection or infusion, Surgery or procedure
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 50 participants
- Where
- 1 siteTurkey (Türkiye)
- Study dates
- 20 Nov 2025to 3 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 years and older
- All sexes
- No healthy volunteers
- Adult, Older adult
Who may be able to join
- Age ≥ 18 years
- ASA physical status I-III
- Scheduled for elective knee arthroscopy under spinal anesthesia
- Ability to provide written informed consent
Who cannot join
- Coagulopathy or bleeding diathesis
- Current use of anticoagulant therapy
- Known allergy or contraindication to local anesthetics used in the study
- History of diabetes mellitus with neuropathy or other neuropathic disorders
- Contraindications to regional anesthesia techniques
- Refusal to participate
Trial locations and contacts
1 site in 1 country.
Turkey (Türkiye)1 site
Health Science University İstanbul Kanuni Sultan Süleyman Education and Training Hospital
Istanbul, küçükçekmece, 34303
About this study
Official title: Comparison of the Analgesic Efficacy of Adductor Canal Block Versus Adductor Canal Plus Biceps Femoris Short Head Block in Patients Undergoing Knee Arthroscopy: A Prospective Randomized Controlled Trial
This prospective, randomized, controlled, and multicenter clinical study aims to compare the postoperative analgesic efficacy of two regional anesthesia techniques commonly used in knee arthroscopy: adductor canal block (ACB) and combined adductor canal block plus biceps femoris short head (ACB+BiFeS) block. The study will evaluate postoperative pain control, opioid consumption, adverse effects, hospital stay, and patient satisfaction. Findings will help determine the most effective and safe method for postoperative analgesia in knee arthroscopy patients.
Read the detailed description
Knee arthroscopy is one of the most common orthopedic procedures and is frequently associated with significant postoperative pain. Effective multimodal analgesia is therefore essential to reduce opioid consumption, improve early mobilization, and enhance overall patient recovery. Among the regional anesthesia techniques, the adductor canal block (ACB) is well established as an effective motor-sparing block that provides analgesia to the medial and anterior aspects of the knee. However, patients often continue to experience posterolateral knee pain, which is not consistently relieved by ACB alone.
Recent anatomical and cadaveric studies have described the biceps femoris short head (BiFeS) block as a promising technique for targeting the posterolateral knee compartment. The BiFeS block involves deposition of local anesthetic between the short head of the biceps femoris muscle and the lateral femoral cortex at the supracondylar level. Preliminary findings suggest that this block may provide effective analgesia for the posterolateral knee without causing significant motor impairment.
This prospective, randomized, controlled, multicenter clinical trial is designed to evaluate whether the addition of the BiFeS block to standard ACB improves postoperative analgesia compared with ACB alone in patients undergoing knee arthroscopy under spinal anesthesia. The study will investigate pain scores at rest and during movement, total opioid consumption, side effects, rescue analgesic requirements, and quality of recovery. The dermatomal distribution of the blocks will be optionally assessed using cold testing.
By directly comparing ACB and combined ACB+BiFeS block under standardized perioperative conditions, this study seeks to generate high-quality evidence on the clinical utility of BiFeS as an adjunct technique. The results are expected to guide anesthesiologists in selecting optimal regional analgesia strategies for knee arthroscopy, with the potential to improve patient satisfaction, reduce opioid-related complications, and shorten hospitalization.
- Conditions
- Postoperative Pain Management
- Being tested
- Adductor Canal Block (ACB) Only, biceps femoris short head block + Adductor Canal Block (ACB)
- Keywords
- regional anesthesia
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Adductor Canal Block (ACB) OnlyProcedure or surgery
Ultrasound-guided injection of 10 mL 0.25% bupivacaine into the adductor canal targeting the femoral artery region, providing motor-sparing analgesia to the medial/anterior knee.
biceps femoris short head block + Adductor Canal Block (ACB)Procedure or surgery
Combination of adductor canal block (10 mL 0.25% bupivacaine) and biceps femoris short head block with 25 mL 0.25% bupivacaine, deposited at the interfascial plane between BiFeS muscle and lateral femoral cortex to extend analgesia to the posterolateral knee.
| Study group | Role | What they receive |
|---|---|---|
| Adductor Canal Block (ACB) | Active comparator | Participants will undergo ultrasound-guided adductor canal block at the end of surgery under spinal anesthesia. Receives: Procedure: Adductor Canal Block (ACB) Only |
| Adductor Canal Block + Biceps Femoris Short Head Block (ACB+BiFeS) | Active comparator | Participants will undergo both adductor canal block and biceps femoris short head block at the end of surgery under spinal anesthesia. Receives: Procedure: biceps femoris short head block + Adductor Canal Block (ACB) |
What is being measured
The primary outcome is the main question the study is designed to answer.
Total Opioid Consumption (Tramadol, mg)
The total dose of tramadol administered via intravenous patient-controlled analgesia (PCA) device within the first 24 hours postoperatively will be recorded in milligrams.
Measured: 24 hours
Secondary outcomes (6)
Postoperative Pain with Movement and at rest (NRS)
Pain intensity during knee movement will be assessed using the Numerical Rating Scale (0-10).
Measured: At 0, 6, 12, and 24 hours after surgery
Rescue Analgesia Requirement
The number of patients requiring rescue analgesia (IV dexketoprofen 50 mg) will be recorded.
Measured: Within the first 24 hours postoperatively
Incidence of Nausea and Vomiting
Presence of nausea/vomiting and the requirement for antiemetic medications will be documented.
Measured: Within the first 24 hours postoperatively
Quality of Recovery (QOR-15 score)
Patient recovery quality will be assessed using the validated Quality of Recovery 15-item questionnaire (QOR-15). The scale includes 15 items, each scored from 0 to 10, producing a total score ranging from 0 to 150.
Minimum score: 0 (poor recovery)
Maximum score: 150 (excellent recovery)
Interpretation: Higher scores indicate better postoperative recovery.
Measured: At 24 hours after surgery
Dermatomal Spread of Block
Sensory block distribution will be assessed using a cold test to map dermatomal coverage.
Measured: 2nd hour postoperatively
Motor Blockade Incidence
Patients will be evaluated for presence or absence of motor weakness attributable to the block.
Measured: Within the first 24 hours postoperatively
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted21 Nov 2025
- Study start20 Nov 2025
- Primary completion3 Apr 2026
- Study completion3 Apr 2026
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Other trials for Postoperative Pain ManagementStudies of the same condition, open and under way.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
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
- Supportive care
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Model description
- Participants will be randomized in a 1:1 ratio to receive either an adductor canal block (ACB) or a combined adductor canal plus biceps femoris short head (ACB+BiFeS) block. Both interventions will be performed under ultrasound guidance at the end of surgery.
- Masking
- Double blind
- Who is masked
- Participant, Outcomes assessor
- Enrolment
- 50 participants (actual)
Sponsor and investigators
- Lead sponsor
- Kanuni Sultan Suleyman Training and Research Hospital
- Sponsor type
- University, hospital or other
- Responsible party
- Principal investigator, Engin Ihsan Turan, Kanuni Sultan Suleyman Training and Research Hospital
- Investigators
- Engin ihsan Turan, Specialist, Principal investigator, Health Science University İstanbul Kanuni Sultan Süleyman Education and Training Hospital
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT07242339
- Sponsor's protocol ID
- Bifes knee
- Acronym
- bifes knee
- Status last verified
- Apr 2026
- First submitted
- 17 Nov 2025
- Last updated
- 7 Apr 2026
- Results posted
- No
- Data monitoring committee
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- No
Study at a glance
From the registry record, last updated by the sponsor on 7 Apr 2026. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Comparison of the Analgesic Efficacy of Adductor Canal Block Versus Adductor Canal Plus Biceps Femoris Short Head Block in Patients Undergoing Knee Arthroscopy: A Prospective Randomized Controlled Trial
- ClinicalTrials.gov ID
- NCT07242339
- Acronym / sponsor ID
- bifes knee / Bifes knee
- Conditions
- Postoperative Pain Management
- Keywords
- regional anesthesia
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 50 participants (actual)
- Lead sponsor
- Kanuni Sultan Suleyman Training and Research HospitalUniversity, hospital or other
- Study start
- 20 Nov 2025 (actual)
- Primary completion
- 3 Apr 2026 (actual)
- Study completion
- 3 Apr 2026 (actual)
- First posted
- 21 Nov 2025 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
This prospective, randomized, controlled, and multicenter clinical study aims to compare the postoperative analgesic efficacy of two regional anesthesia techniques commonly used in knee arthroscopy: adductor canal block (ACB) and combined adductor canal block plus biceps femoris short head (ACB+BiFeS) block. The study will evaluate postoperative pain control, opioid consumption, adverse effects, hospital stay, and patient satisfaction. Findings will help determine the most effective and safe method for postoperative analgesia in knee arthroscopy patients.
Detailed description
Knee arthroscopy is one of the most common orthopedic procedures and is frequently associated with significant postoperative pain. Effective multimodal analgesia is therefore essential to reduce opioid consumption, improve early mobilization, and enhance overall patient recovery. Among the regional anesthesia techniques, the adductor canal block (ACB) is well established as an effective motor-sparing block that provides analgesia to the medial and anterior aspects of the knee. However, patients often continue to experience posterolateral knee pain, which is not consistently relieved by ACB alone.
Recent anatomical and cadaveric studies have described the biceps femoris short head (BiFeS) block as a promising technique for targeting the posterolateral knee compartment. The BiFeS block involves deposition of local anesthetic between the short head of the biceps femoris muscle and the lateral femoral cortex at the supracondylar level. Preliminary findings suggest that this block may provide effective analgesia for the posterolateral knee without causing significant motor impairment.
This prospective, randomized, controlled, multicenter clinical trial is designed to evaluate whether the addition of the BiFeS block to standard ACB improves postoperative analgesia compared with ACB alone in patients undergoing knee arthroscopy under spinal anesthesia. The study will investigate pain scores at rest and during movement, total opioid consumption, side effects, rescue analgesic requirements, and quality of recovery. The dermatomal distribution of the blocks will be optionally assessed using cold testing.
By directly comparing ACB and combined ACB+BiFeS block under standardized perioperative conditions, this study seeks to generate high-quality evidence on the clinical utility of BiFeS as an adjunct technique. The results are expected to guide anesthesiologists in selecting optimal regional analgesia strategies for knee arthroscopy, with the potential to improve patient satisfaction, reduce opioid-related complications, and shorten hospitalization.
Study design
- Primary purpose
- Supportive care
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Double blind (participant, outcomes assessor)
- Number of arms
- 2
- Model description
- Participants will be randomized in a 1:1 ratio to receive either an adductor canal block (ACB) or a combined adductor canal plus biceps femoris short head (ACB+BiFeS) block. Both interventions will be performed under ultrasound guidance at the end of surgery.
| Arm | Type | Receives |
|---|---|---|
| Adductor Canal Block (ACB) | Active comparator | Procedure: Adductor Canal Block (ACB) OnlyParticipants will undergo ultrasound-guided adductor canal block at the end of surgery under spinal anesthesia. |
| Adductor Canal Block + Biceps Femoris Short Head Block (ACB+BiFeS) | Active comparator | Procedure: biceps femoris short head block + Adductor Canal Block (ACB)Participants will undergo both adductor canal block and biceps femoris short head block at the end of surgery under spinal anesthesia. |
Who may qualify
- Ages
- 18 years and older
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (4 listed)
- Age ≥ 18 years
- ASA physical status I-III
- Scheduled for elective knee arthroscopy under spinal anesthesia
- Ability to provide written informed consent
Key exclusion criteria (6 listed)
- Coagulopathy or bleeding diathesis
- Current use of anticoagulant therapy
- Known allergy or contraindication to local anesthetics used in the study
- History of diabetes mellitus with neuropathy or other neuropathic disorders
- Contraindications to regional anesthesia techniques
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| Adductor Canal Block (ACB) OnlyUltrasound-guided injection of 10 mL 0.25% bupivacaine into the adductor canal targeting the femoral artery region, providing motor-sparing analgesia to the medial/anterior knee. | Procedure or surgery | Adductor Canal Block (ACB) |
| biceps femoris short head block + Adductor Canal Block (ACB)Combination of adductor canal block (10 mL 0.25% bupivacaine) and biceps femoris short head block with 25 mL 0.25% bupivacaine, deposited at the interfascial plane between BiFeS muscle and lateral femoral cortex to extend analgesia to the posterolateral knee. | Procedure or surgery | Adductor Canal Block + Biceps Femoris Short Head Block (ACB+BiFeS) |
Primary outcome
Total Opioid Consumption (Tramadol, mg)
Time frame: 24 hours
The total dose of tramadol administered via intravenous patient-controlled analgesia (PCA) device within the first 24 hours postoperatively will be recorded in milligrams.
6 secondary outcomes
Postoperative Pain with Movement and at rest (NRS)
Time frame: At 0, 6, 12, and 24 hours after surgery
Rescue Analgesia Requirement
Time frame: Within the first 24 hours postoperatively
Incidence of Nausea and Vomiting
Time frame: Within the first 24 hours postoperatively
Quality of Recovery (QOR-15 score)
Time frame: At 24 hours after surgery
Dermatomal Spread of Block
Time frame: 2nd hour postoperatively
Motor Blockade Incidence
Time frame: Within the first 24 hours postoperatively
Results and safety
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 7 Apr 2026.
- Individual participant dataSharing planned: No
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
Engin ihsan Turan, Specialist principal investigator
Health Science University İstanbul Kanuni Sultan Süleyman Education and Training Hospital
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing Adductor Canal Block (ACB) Only and biceps femoris short head block + Adductor Canal Block (ACB) in people with Postoperative Pain Management, run by Kanuni Sultan Suleyman Training and Research 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?
The sponsor lists 4 inclusion and 6 exclusion criteria. 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 7 Apr 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?
Total Opioid Consumption (Tramadol, mg) (time frame: 24 hours). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
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 7 Apr 2026.