Effect of pectineus muscle plane block versus femoral nerve block for postoperative analgesia and early recovery after knee surgery: a randomised controlled trial study protocol

Abstract

Background Femoral nerve block (FNB) is a prevalent method used for postoperative pain management after knee surgery; however, it decreases the strength of the quadriceps muscle and is not conducive to early recovery after surgery. Pectineus muscle plane (PMP) block involves the injection of a local anaesthetic into the fascial plane below the pectineus muscle, where it blocks the obturator and saphenous nerves. However, there is little evidence on the effectiveness of PMP block for analgesia after knee surgery. The aim of this trial is to assess whether PMP block can improve postoperative analgesia, promote early recovery and reduce the length of hospital stay.Methods and analysis In this randomised controlled study, 46 patients will be randomly allocated into two groups: the PMP block group (n=23) and the FNB group (n=23). The primary outcome measures will include Visual Analog Scale scores for pain at rest and during movement at various time points following knee surgery. Secondary outcomes will include the degree of active flexion, straight leg raise test performance, get-out-of-bed test result, 20 m walk test result, total dose administered via patient-controlled analgesia infusion pumps, hospital stay duration, patient satisfaction and postoperative complications, such as pulmonary embolism and deep vein thrombosis.This study protocol adheres to rigorous standards for ethical conduct and patient safety. The findings from this trial are expected to contribute valuable insights to the optimisation of postoperative pain management strategies and the improvement of early recovery outcomes for patients who undergo knee surgery.Ethics and dissemination This trial has been approved by the ethics committee of Zhejiang Hospital (2022(128K)) on 17 November 2022, and inpatients who meet the inclusion criteria and diagnostic requirements are eligible for this study. Any subsequent protocol and informed consent document amendments must be approved by the responsible ethics committee. All communications with the regulatory authorities and the ethics committee must be recorded. All recruited patients will be informed of the trial purposes and their duties within the trial before randomisation. Recruited patients can withdraw from the study at any time without providing any specific reason. The patient data will be stored in a separate, safe place, but that it may be reviewed by the relevant investigator. The results will be published in international peer-reviewed medical journals.Trial registration number http://www.chictr.org.cn, ID: ChiCTR2300076018. Registered on 21 September 2023.