Ultrasound Guided Obturator Nerve Block for Anterior Cruciate Ligament Reconstruction (ACL)

Study Overview
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Brief Summary
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Anterior Cruciate Ligament ACL reconstruction can be performed under the combination of posterior lumbar plexus block plus sciatic nerve block. The investigators can have the same outcome by performing instead of posterior lumbar plexus block more peripheral nerve blocks. More specifically under the combination of sciatic nerve block plus femoral nerve block plus obturator nerve block.

Official Title
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Comparison of Posterior Lumbar Plexus Block Plus Sciatic Nerve Block With Sciatic Plus Femoral Plus Obturator Nerve Block for Anterior Cruciate Ligament Reconstruction

Conditions
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Anterior Cruciate Ligament, Surgery

Intervention / Treatment
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* Other: Sciatic, femoral, obturator nerve blocks
* Other: Sciatic nerve block, posterior lumbar plexus block


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Age 18-50 years old ASA I - II ACL reconstruction surgery Exclusion Criteria: Coagulopathy disorders Infection at the puncture site for the interscalene block Neurologic deficit in the arm that is going to be operated Allergy to local anesthetics BMI > 35 Psychiatric disorders Patient's refusal Problems with patient communication

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 50 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Supportive Care
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Triple


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Active Comparator: ACL, sciatic, femoral, obturator<br>ACL reconstruction surgery under ultrasound guided sciatic nerve block plus femoral nerve block plus obturator nerve block | Other: Sciatic, femoral, obturator nerve blocks<br>* Ultrasound guided blocks with ropivacaine<br>|
| Active Comparator: ACL, sciatic nerve block, posterior lumbar plexus block<br>ACL reconstruction surgery under ultrasound guided sciatic nerve block plus posterior lumbar plexus block | Other: Sciatic nerve block, posterior lumbar plexus block<br>* Ultrasound and neurostimulator nerve blocks with ropivacaine<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Feasibility of ACL reconstruction surgery under ultrasound guided sciatic nerve block plus femoral nerve block plus obturator nerve block measured with Pain Score on the Visual Analog Scale | If the patient complains for pain > 4 in VAS and there is no relief with fentanyl administration the anesthesia plan converts to general anesthesia with laryngeal mask | 45 min | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Intraoperative opioid consumption for ACL reconstruction surgery under ultrasound guided sciatic nerve block plus femoral nerve block plus obturator nerve block |  | Intraoperatively | 
| Postoperative opioid consumption for ACL reconstruction surgery under ultrasound guided sciatic nerve block plus femoral nerve block plus obturator nerve block |  | 24h | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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anterior cruciate ligament reconstruction, obturator nerve block, sciatic nerve block, femoral nerve block, posterior lumbar plexus block, ultrasound guided nerve block