---
title: Comparison Between Combined Biceps Femoris Short Head Block and Adductor Canal Block Versus Genicular Nerve Block
nct_id: NCT07418307
overall_status: NOT_YET_RECRUITING
phase: NA
sponsor: Zagazig University
study_type: INTERVENTIONAL
primary_condition: Knee Arthroplasty, Total
countries: Egypt
canonical_url: "https://parkinsonspathways.com/agent/trials/NCT07418307.md"
clinicaltrials_gov: "https://clinicaltrials.gov/study/NCT07418307"
ct_last_update_post_date: 2026-02-18
last_seen_at: "2026-05-12T06:32:51.885Z"
source: ClinicalTrials.gov (mirrored, no enrichment)
---
# Comparison Between Combined Biceps Femoris Short Head Block and Adductor Canal Block Versus Genicular Nerve Block

**Official Title:** Enhanced Analgesia in Elderly After Total Knee Arthroplasty Using Combined Biceps Femoris Short Head Block and Adductor Canal Block Versus Genicular Nerve Block

**NCT ID:** [NCT07418307](https://clinicaltrials.gov/study/NCT07418307)

## Key Facts

- **Status:** NOT_YET_RECRUITING
- **Phase:** NA
- **Study Type:** INTERVENTIONAL
- **Target Enrollment:** 50
- **Lead Sponsor:** Zagazig University
- **Conditions:** Knee Arthroplasty, Total
- **Start Date:** 2026-02-15
- **Completion Date:** 2026-11-15
- **CT.gov Last Update:** 2026-02-18

## Brief Summary

The purpose of this study is to compare the analgesic outcomes (time to first analgesic request, total amount of analgesic consumption, and pain scores) following total knee arthroplasty by either combined biceps femoris short head block and adductor canal block or genicular nerve block in elderly patients.

## Eligibility

- **Minimum age:** 65 Years
- **Sex:** ALL
- **Healthy Volunteers:** No

```
Inclusion Criteria:

* patient acceptance
* Physical status: ASA I, II and Ⅲ.
* Body mass index (BMI): 18.5 - 35 kg/m2.
* Type of operations: total knee arthroplasty.

Exclusion Criteria:

* Known hypersensitivity to dexamethasone or bupivacaine.
* Coagulation disorders or taking drugs affect surgical hemostasis.
* Patients with pre-existing neurological deficits.
* Uncooperative patient or with altered mental status.
* Patient with advanced cardiovascular or respiratory diseases or uncontrolled diabetes
```

## Arms

- **Group (C)** (ACTIVE_COMPARATOR) — The patient will receive combined biceps femoris short head block and adductor canal block
- **Group(G)** (ACTIVE_COMPARATOR) — The patient will receive genicular nerve block

## Interventions

- **Combined biceps femoris short head block and adductor canal block** (OTHER) — Adductor Canal Block high-frequency probe will be placed transversely on the anterior thigh midpoint between inguinal crease and medial condyle (depth 3-5 cm). The needle will be advanced in-plane from lateral to medial through sartorius or vastus medialis muscle toward the femoral artery. Then (10 ml of 0.25% bupivacaine and 2 mg dexamethasone) will be injected after negative aspiration, with confirming spread around the artery without vascular puncture.

Biceps femoris short head block The probe will be placed on the distal posterior thigh to visualize biceps femoris muscle near the lateral supracondylar line of the femur. The needle will be inserted to the interface between biceps femoris and femur cortex. Then (25 ml of 0.25% bupivacaine and 2 mg dexamethasone), with observing muscle lift and circumferential spread along the bone surface .
- **Genicular nerve block** (OTHER) — Position the patient will be placed in supine position with the knee slightly flexed via a pillow in the popliteal fossa. Use a high-frequency linear ultrasound transducer.

Superolateral genicular nerve (SLGN): the transducer will be placed coronally over lateral femoral epicondyle, with sliding proximally to femur metaphysis; identifying artery between vastus lateralis fascia and bone.

Superomedial genicular nerve (SMGN): the transducer will be placed coronally over medial femoral epicondyle, proximal to adductor tubercle at femur metaphysis; artery between vastus medialis fascia and bone.

Inferomedial genicular nerve (IMGN): the transducer will be placed coronally over medial tibial condyle, distal to metaphysis; artery beneath medial collateral ligament.

• Inferolateral genicular nerve (ILGN, optional): the transducer will be placed coronally over lateral tibial epicondyle to fibula head; artery between collateral ligament and tibia

## Primary Outcomes

- **Time of first rescue analgesia (naluphine)** _(time frame: 24 hours postoperative)_ — to the duration from the block to the moment when the patient first requires or requests supplemental nalbuphine due to breakthrough pain

## Secondary Outcomes

- **block performance time** _(time frame: time of performance of the block)_
- **Pain intensity** _(time frame: 30 minutesn2, 4, 8, 12, 18 , and 24 hours postoperative)_
- **Total amount of rescue analgesia (nalbuphine)** _(time frame: first 24 hours postoperative)_
- **assess functional recovery** _(time frame: at 12 hours and 24 hours postoperative)_
- **patient's satisfaction** _(time frame: 24 hours postoperative)_
- **Block related complications** _(time frame: 24 hours postoperative)_

## Locations (1)

- Faculty of Medicine,Zagazig University, Zagazig, Egypt

## Recent Field Changes (last 30 days)

- `sponsor.lead` — added _(2026-05-12)_
- `results.hasResults` — added _(2026-05-12)_
- `status.overallStatus` — added _(2026-05-12)_
- `status.primaryCompletionDate` — added _(2026-05-12)_
- `status.completionDate` — added _(2026-05-12)_
- `status.lastUpdatePostDate` — added _(2026-05-12)_
- `design.phases` — added _(2026-05-12)_
- `design.enrollmentCount` — added _(2026-05-12)_
- `eligibility.criteria` — added _(2026-05-12)_
- `eligibility.minAge` — added _(2026-05-12)_
- `eligibility.sex` — added _(2026-05-12)_
- `outcomes.primary` — added _(2026-05-12)_
- `outcomes.secondary` — added _(2026-05-12)_
- `armsInterventions.arms` — added _(2026-05-12)_
- `armsInterventions.interventions` — added _(2026-05-12)_
- `locations.faculty of medicine,zagazig university|zagazig||egypt` — added _(2026-05-12)_

---

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*Source data (authoritative): https://clinicaltrials.gov/study/NCT07418307*  
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