Comparison of Analgesic Effects of ACB Versus ACB Combined With BiFeS Block in ACL Reconstruction Surgery

Anterior cruciate ligament (ACL) reconstruction is commonly associated with moderate to severe postoperative pain, particularly during the early postoperative period and rehabilitation. Effective postoperative analgesia is important to facilitate early mobilization, improve patient comfort, and reduce opioid consumption and opioid-related adverse effects. Adductor canal block (ACB) is commonly used as part of multimodal analgesia for knee surgery because it provides analgesia while largely preserving quadriceps motor function. However, ACB primarily targets the anteromedial aspect of the knee and may provide limited analgesia for pain arising from the posterior and posterolateral knee. The biceps femoris short head (BiFeS) block is a motor-sparing fascial plane block targeting sensory contributions to the posterolateral knee region. Combining BiFeS block with ACB may therefore provide more comprehensive analgesia than ACB alone. This randomized study aims to compare the postoperative analgesic efficacy of adductor canal block alone with adductor canal block combined with BiFeS block in patients undergoing anterior cruciate ligament reconstruction surgery.

Inclusion Criteria: * Patients aged 18-65 years * Patients scheduled for elective unilateral anterior cruciate ligament reconstruction surgery * American Society of Anesthesiologists physical status I-III * Patients who provide written informed consent Exclusion Criteria: * Age \65 years * ASA physical status IV or higher * Coagulopathy or ongoing anticoagulant therapy incompatible with peripheral nerve block * Infection at the block injection site * Patient refusal