{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T17:16:09Z","timestamp":1792170969500,"version":"4.4.0"},"reference-count":18,"publisher":"BMJ","funder":[{"name":"Aarhus University, Denmark"},{"DOI":"10.13039\/501100010078","name":"Central Denmark Region","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100010078","id-type":"DOI","asserted-by":"crossref"}]},{"name":"The Danish Rheumatism Association"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Reg Anesth Pain Med"],"accepted":{"date-parts":[[2026,3,3]]},"abstract":"<jats:sec>\n                    <jats:title>Background and objectives<\/jats:title>\n                    <jats:p>The popliteal plexus block is a motor-sparing regional anesthetic technique used as an adjunct to multimodal analgesia after total knee arthroplasty. Clinical studies have used varying local anesthetic volumes for the block, reflecting uncertainty regarding the optimal volume. This randomized clinical trial aimed to determine whether using 20\u2009mL of local anesthetic for the popliteal plexus block provides superior analgesic efficacy and early functional outcomes compared with 10\u2009mL after total knee arthroplasty.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In this single-center, blinded, randomized controlled trial, 120 adults undergoing primary unilateral total knee arthroplasty under spinal anesthesia were randomized to receive a popliteal plexus block with either 10\u2009mL or 20\u2009mL of bupivacaine 5\u2009mg\/mL, in addition to a standardized multimodal analgesic regimen including a femoral triangle block. The primary outcome was 24-hour postoperative opioid consumption. Secondary outcomes included the proportion of patients achieving opioid-free analgesia, pain scores, early functional outcomes and patient-reported Quality of Recovery-15.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>No statistically significant or clinically relevant differences were observed between the two groups in 24-hour postoperative opioid consumption (median 15 (IQR 3.75\u201330)\u2009vs 15\u2009mg (IQR 0\u201330)\u2009oral morphine milligram equivalents; median difference 0\u2009mg, 95%\u2009CI \u221210 to 5; p=0.6), the proportion of patients achieving opioid-free analgesia, pain at rest or during ambulation, ability to ambulate with crutches, motor impairment, or patient-reported quality of recovery.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Use of 20\u2009mL of local anesthetic for the popliteal plexus block as part of a multimodal analgesic regimen after total knee arthroplasty does not provide superior analgesic efficacy or improved functional outcomes compared with 10\u2009mL. Consistent with the principle of using the lowest effective dose and minimizing cumulative local anesthetic exposure, these findings support the use of 10\u2009mL of local anesthetic for popliteal plexus block in clinical practice and in future research.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial registration number<\/jats:title>\n                    <jats:p>EUCT number: 2024-520204-26-00.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/rapm-2026-107696","type":"journal-article","created":{"date-parts":[[2026,3,18]],"date-time":"2026-03-18T14:25:23Z","timestamp":1773843923000},"page":"rapm-2026-107696","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["Analgesic efficacy and functional outcomes of 10 versus 20 mL bupivacaine for popliteal plexus block after total knee arthroplasty: a randomized clinical trial"],"prefix":"10.1136","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-0087-3719","authenticated-orcid":false,"given":"Johan Kl\u00f8vgaard","family":"S\u00f8rensen","sequence":"first","affiliation":[{"name":"Department of Clinical Medicine, Aarhus University, Aarhus, Denmark"},{"name":"Elective Surgery Centre, Silkeborg Regional Hospital, Silkeborg, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mikkel Schj\u00f8dt Heide","family":"Jensen","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology, Silkeborg Regional Hospital, Silkeborg, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ulrik","family":"Grevstad","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Gentofte Hospital, Hellerup, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lone","family":"Nikolajsen","sequence":"additional","affiliation":[{"name":"Department of Clinical Medicine, Aarhus University, Aarhus, Denmark"},{"name":"Department of Anaesthesiology, Aarhus University Hospital, Aarhus, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charlotte","family":"Runge","sequence":"additional","affiliation":[{"name":"Department of Clinical Medicine, Aarhus University, Aarhus, Denmark"},{"name":"Elective Surgery Centre, Silkeborg Regional Hospital, Silkeborg, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2026,3,18]]},"reference":[{"key":"2026031807251388000_rapm-2026-107696v1.1","doi-asserted-by":"publisher","DOI":"10.1007\/s11999-017-5377-7"},{"key":"2026031807251388000_rapm-2026-107696v1.2","doi-asserted-by":"publisher","DOI":"10.1016\/j.joca.2017.07.022"},{"key":"2026031807251388000_rapm-2026-107696v1.3","doi-asserted-by":"crossref","first-page":"743","DOI":"10.1097\/EJA.0000000000001691","article-title":"Pain management after total knee arthroplasty: PROcedure SPEcific Postoperative Pain ManagemenT recommendations","volume":"39","author":"Lavand\u2019homme","year":"2022","journal-title":"Eur J Anaesthesiol"},{"key":"2026031807251388000_rapm-2026-107696v1.4","doi-asserted-by":"publisher","DOI":"10.1097\/AAP.0000000000000675"},{"key":"2026031807251388000_rapm-2026-107696v1.5","doi-asserted-by":"crossref","unstructured":"Fujino T , Taga K , Odo M , et al . Analgesic efficacy of popliteal plexus block versus infiltration between the popliteal artery and capsule of the posterior knee block combined with femoral triangle block after total knee arthroplasty: a randomized non-inferiority trial and cadaveric evaluation. 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Effect of local anesthetic volume for popliteal plexus block on motor nerve conduction and muscle function in the leg: a randomized clinical trial in healthy volunteers. 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