Ultrasound Guided Adductor Canal Block Versus Femoral Nerve Block for Quadriceps Strength and Fall-risk

Overview

Our objective was to determine if an ultrasound guided ACB can preserve quadriceps strength, thus minimizing weakness of knee extension compared with ultrasound guided femoral nerve block. Our primary outcome was the percent of maximum voluntary isometric contraction (MVIC) of knee extension preserved at 30 mins after either an ACB or FNB. Secondary outcomes included MVIC of knee extension at 60 min, hip adduction at 30 and 60 mins, and assessment of fall risk with the Berg Balance Scale (BBS) at 30 minutes.

Full Title of Study: “The Effects of Ultrasound Guided Adductor Canal Block Versus Femoral Nerve Block on Quadriceps Strength and Fall-risk: a Blinded Randomized Trial of Volunteers”

Study Type

  • Study Type: Interventional
  • Study Design
    • Allocation: Randomized
    • Intervention Model: Parallel Assignment
    • Primary Purpose: Treatment
    • Masking: Triple (Participant, Investigator, Outcomes Assessor)
  • Study Primary Completion Date: June 2012

Interventions

  • Procedure: Ultrasound Guided Adductor Canal Block
  • Procedure: Ultrasound Guided Femoral Nerve Block

Arms, Groups and Cohorts

  • Experimental: Adductor Canal block first
    • This arm received an ultrasound guided adductor canal block with 15mL of chloroprocaine 3% followed by motor, sensory and balance assessments. Then the patients received an ultrasound guided femoral nerve block with 15mL of chloroprocaine 3% followed by sensory and motor assessments.
  • Experimental: Femoral nerve block first
    • This arm received an ultrasound guided femoral nerve block with 15mL of chloroprocaine 3% followed by motor, sensory and balance assessments. Then the patients received an ultrasound guided adductor canal block with 15mL of chloroprocaine 3% followed by sensory and motor assessments.

Clinical Trial Outcome Measures

Primary Measures

  • Percent of maximum voluntary isometric contraction (MVIC) of knee extension preserved at 30 mins after either an ACB or FNB
    • Time Frame: At 30 minutes

Secondary Measures

  • Percent of maximum voluntary isometric contraction (MVIC) of knee extension preserved at 60 mins after either an ACB or FNB
    • Time Frame: At 60 minutes
  • Percent of maximum voluntary isometric contraction (MVIC) of hip adduction preserved at 30 mins after either an ACB or FNB
    • Time Frame: At 30 minutes
  • Percent of maximum voluntary isometric contraction (MVIC) of hip adduction preserved at 60 mins after either an ACB or FNB
    • Time Frame: At 60 minutes
  • Assessment of fall risk with the Berg Balance Scale (BBS) at 30 minutes after the first nerve block.
    • Time Frame: At 30 minutes

Participating in This Clinical Trial

Inclusion Criteria

  • Adults (>18yrs) – ASA 1-2 Exclusion Criteria:

  • BMI >30 – Allergy to local anesthetics – Pre-existing gait disturbance – Pre-existing neuropathy

Gender Eligibility: All

Minimum Age: 18 Years

Maximum Age: 65 Years

Are Healthy Volunteers Accepted: Accepts Healthy Volunteers

Investigator Details

  • Lead Sponsor
    • St. Luke’s-Roosevelt Hospital Center
  • Provider of Information About this Clinical Study
    • Principal Investigator: Jeff Gadsden, Director of Regional Anesthesia – St. Luke’s-Roosevelt Hospital Center

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