Study protocol of a patient-blinded, randomized controlled trial of the analgesic efficacy of low adductor canal block in total knee arthroplasty
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Background:Pain management after total knee arthroplasty (TKA) has been identified as a patient priority. Adductor canal block (ACB) is a major component of multimodal analgesia strategies. The commonly used technique is ultrasound-guided ACB (referred to as high ACB); however, the necessity of specialized equipment and expertise may limit its application in the operating room. Low adductor canal block (referred to as low ACB), guided by the tendon of the adductor magnus muscle, has been proved feasible in cadaver studies.This randomized controlled trial aims to evaluate the clinical effectiveness of low ACB guided by the tendon of the adductor magnus muscle for postoperative pain management after TKA. Methods:This study is a patient-blinded, single-center, equivalence, two-arm, parallel-group randomized controlled trial. A total of 280 patients scheduled for total knee arthroplasty (TKA) will be recruited and randomly assigned to either the low adductor canal block (ACB) group or the high ACB group.The primary outcome measure is the cumulative pain assessed within 72 hours postoperatively using a 0-10 Numeric Rating Scale (NRS),summarized by the area under the curve. Secondary outcomes include the number and proportion of patients meeting discharge criteria within 24 hours postoperatively, cumulative opioid consumption within 72 hours postoperatively, functional outcomes assessed using the Oxford Knee Score (OKS) and the American Knee Society Score (KSS), discharge satisfaction, and complications. Discussion:The clinical effectiveness of low adductor canal block using the tendon of the adductor magnus as a guide for postoperative analgesia after total knee arthroplasty has not yet been evaluated,making this trial appropriate and timely. Trial registration:This study has been registered on www.chictr.org.cn. The registration number:ChiCTR2500097749,registered on February 25th, 2025.
