Comparing Biceps Femoris Short Head and Adductor Canal Blocks for Pain Relief After Total Knee Replacement Surgery

What this Trial Is About

This research aims to evaluate how combining ultrasound-guided Biceps Femoris Short Head BiFeS block with adductor canal block affects opioid use and pain control after total knee replacement surgery. The study includes 60 adult patients aged 18 to 80 years with ASA physical status I-III undergoing elective unilateral total knee arthroplasty under spinal anesthesia. Researchers want to see if adding these nerve blocks improves pain relief compared to standard care. Participants will be randomly assigned to one of two groups. The intervention group receives spinal anesthesia followed by ultrasound-guided BiFeS block with 25 mL of 0.25% bupivacaine and adductor canal block with 15 mL of 0.25% bupivacaine before surgery, plus standard multimodal analgesia. The control group receives spinal anesthesia alone with the same standard analgesia. All patients will have postoperative morphine patient-controlled analgesia PCA for 24 hours, with rescue fentanyl available for severe pain. During the study, participants total morphine consumption in the first 24 hours after surgery is measured as the primary outcome. Secondary outcomes include pain scores at 1, 6, 12, and 24 hours post-surgery, time until first pain medication needed, time to first foot movement, rescue analgesic use, and quality of recovery scores. Assessments include pain scales and patient recovery questionnaires, with close monitoring to understand the benefits of adding nerve blocks to pain management after knee surgery.

Biceps Femoris Short Head (BiFeS) Block and Adductor Canal Block for Postoperative Analgesia Following Total Knee Arthroplasty