Clinical trial NCT06245460: Evaluation by Ultrasound Imaging of Local Anesthetic Spread to the Popliteal Fossa During an Adductor Canal Block
Official title: Evaluation by Ultrasound Imaging of Local Anesthetic Spread to the Popliteal Fossa During an Adductor Canal Block
Study type: OBSERVATIONAL
Overall status: RECRUITING
Conditions: Knee Injuries
Keywords: knee surgery
ultrasound
analgesia
pain
Lead sponsor: Assistance Publique - Hôpitaux de Paris
Sponsor class: OTHER
First posted: 2024-02-07
Enrollment: 100
Sex: ALL
Minimum age (years): 18
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Observational model: COHORT
Time perspective: PROSPECTIVE
Sampling method: NON_PROBABILITY_SAMPLE
Study population: The study population will be all the consecutive patients scheduled for elective knee surgery under general anesthesia in our center and receiving an adductor canal block.

Brief summary: Adductor canal block is an effective analgesic technique for major knee surgery. However, the saphenous nerve block is not sufficient to explain this block's efficiency. It has been shown that adductor canal block can spread to the tibial and fibular nerves through the adductor hiatus. However this diffusion's frequency has never been measured. The main objective of this study is to assess the frequency of the spread of the adductor canal block to the fibular and tibial nerves assessed by ultrasound observation at the popliteal fossa.

Detailed description: Adductor canal block is an effective analgesic technique for major knee surgery. The PROSPECT group recommends this block in first intention for locoregional anesthesia in total knee arthroplasty. It has been shown to not be inferior to femoral nerve block in this indication.

The adductor canal block targets the saphenous nerve and, through its spread in the adductor canal, the posterior branch of obturator nerve and the vastus medialis nerve. However these nerves can't fully explain this block's efficiency.

It has been shown that local anesthetic can spread in the adductor canal to the tibial and fibular nerves through the adductor hiatus. However, this spread is inconstant, and no study has evaluated the frequency of this spread yet.

The main objective of this study is to assess the diffusion's frequency of adductor canal block to fibular and tibial nerves through ultrasound observation at the popliteal fossa.

Eligibility criteria: Inclusion Criteria:

* patients scheduled for elective knee surgery under general anesthesia
* in center of Ambroise Paré hospital
* receiving an adductor canal block

Exclusion Criteria:

* patients cognitively impaired
* patients suffering from peripheral neuropathy at the lower limb
* patients receiving an IPACK block or surgical knee infiltration to complete the adductor canal block analgesia
* patients who refused to take part in this study
* pregnant or breastfeeding patients
* patients under guardianship
* imprisoned patients
* patients without any medical insurance

Primary outcomes:
measure: Frequency of local anesthetic's spread
timeFrame: at baseline
Secondary outcomes:
measure: Frequency of altered sensibility
timeFrame: at one and four hours
measure: Correlation between local anesthetic spread and clinical alteration
timeFrame: at baseline, hour 1 and hour 4th
Other outcomes:
Locations:
city: Boulogne-Billancourt
country: France
facility: Department of anesthesia, Ambroise Paré Hospital - APHP
Study officials:
affiliation: Department of anesthesia, Ambroise Paré Hospital - APHP
name: Romuald Henry, MD
role: PRINCIPAL_INVESTIGATOR
References: