RECRUITING Not applicable ClinicalTrials.gov

Combined Distal Femoral Nerve Block for Pain Control After Knee Replacement

Sponsor: GCS Ramsay Santé pour l'Enseignement et la Recherche • ClinicalTrials.gov ID: NCT07629388

Registry updated: 2026-10-05

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Description

The goal of this clinical trial is to see whether a combined distal femoral nerve block improves pain relief after total knee replacement in adults having planned surgery. The main questions it aims to answer are: * Does the combined distal femoral nerve block reduce the amount of opioid needed in the post-anesthesia recovery room? * Does it preserve quadriceps muscle strength while improving postoperative pain control? Researchers will compare the combined distal femoral nerve block to a saphenous nerve block alone to see if the combined block provides better analgesia without reducing leg strength. Participants will: * Receive either the combined distal femoral nerve block or the saphenous nerve block alone before surgery. * Also receive standard multimodal pain management, including anesthesia, surgical site infiltration, and postoperative pain medications. * Be assessed for pain, opioid use, nausea and vomiting, quadriceps strength, time to first standing, hospital stay length, and patient satisfaction from surgery until discharge.

Interventions

Combined distal femoral nerve block (Procedure)
Ultrasound-guided block targeting the saphenous nerve, vastus medialis nerve, and anterior femoral cutaneous nerves, using ropivacaine 2 mg/mL, 40 mL total, with clonidine 30 micrograms perineural and dexamethasone 8 mg IV.
Saphenous nerve block alone (Procedure)
Ultrasound-guided saphenous nerve block at the adductor canal, using ropivacaine 2 mg/mL, 20 mL total, with clonidine 30 micrograms perineural and dexamethasone 8 mg IV.
Standard perioperative care in both groups (Procedure)
General anesthesia, surgical site infiltration, and multimodal analgesia with paracetamol, nefopam, and ketoprofen.

Eligibility criteria

Inclusion Criteria: * Adult patients aged over 18 years. * Scheduled for total knee arthroplasty with multimodal analgesia. * Affiliated with or benefiting from a social security system. * Able to understand the study information and provide written informed consent. Exclusion Criteria: * Emergency surgery. * Weight under 50 kg. * Body mass index over 40 kg/m². * Contraindication to nefopam, non-steroidal anti-inflammatory drugs, local anesthetics, or morphine. * Preoperative opioid use. * Antidepressant or gabapentinoid treatment. * Other planned surgical or medical procedures during the study period. * Participation in another clinical trial, or currently in an exclusion period from another trial. * Inability to understand study information for linguistic, psychological, cognitive, or literacy reasons. * Pregnancy, possible pregnancy without effective contraception, or breastfeeding. * Protected adults, including those under guardianship, curatorship, legal protection, detention, or otherwise unable to give informed consent.

Conditions

Pain After Total Knee Arthroplasty Pain Management

Locations

Hôpital privé Dijon Bourgogne — Dijon, France

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Official Source

Data sourced from ClinicalTrials.gov, a service of the U.S. National Institutes of Health.

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