NCT04295421

IPACK Block After Total Knee Arthroplasty

Comparison of Adductor Canal Block and IPACK Block With Adductor Canal Block Alone After Total Knee Arthroplasty

• Status: Completed
• Phase: N/A
• Study type: Interventional
• Enrollment: 88 (actual)
• Sponsor: University Tunis El Manar · Academic / Other
• Sex: All
• Age: —
• Healthy volunteers: Not accepted

Summary

Adductor canal block (ACB) is a peripheral nerve blockade technique that provides good pain control in patients undergoing total knee arthroplasty (TKA) which however does not relieve posterior knee pain. The recent technique of an ultrasound-guided local anesthetic infiltration of the interspace between popliteal artery and the capsule of posterior knee (IPACK) has shown promising results in providing significant posterior knee analgesia without affecting the motor nerves. The hypothesis was that the combination of ACB + IPACK will provide better pain relief and improve knee function in the immediate postoperative period compared to ACB alone.

Detailed description

This is a prospective, randomized and double blinded study All patients received : * Pregabalin 150 mg preoperatively 12 h before the surgery. * Single-shot spinal anesthesia with 10 to 12 mg of bupivacaine 0.5% and 2.5ug sufentanil patients were randomly allocated to receive: * Group 1: IPACK + ACB single shoot * Group 2: contineous ACB For group 1: IPACK was realized after spinal anesthesia with 40 ml ropivacaine 0.2% All patients received ACB in the immediate postoperative period with 20 ml ropivacaine 0.2% Post operative analgesia included: * Paracetamol 1g IV every 6 hours * Diclofenac sodium (50mg) 1 tablet x 2 per day * Pregabalin 150 mg given orally once daily for a period of 4 weeks. * PCA morphine (Patient Controlled Analgesia), as a rescue analgesia, * Continuous ACB catheter for 48H with : 4 ml per hour 0.2% ropivacaine in group 2 4 ml per hour saline in group 1

Conditions

• Knee Arthropathy
• Postoperative Pain

Interventions

Type	Name	Description
PROCEDURE	adductor canal block	ACB was done in the immediate postoperative period under a high-frequency ultrasound guidance in which the adductor canal was identified beneath the sartorius muscle and 20 ml of 0.2% ropivacaine was injected in the canal using a 22-gauge 100-mm short-beveled regional block needle and a catheter was kept for 48H with 4 ml/h ropivacaine 0.2%.
PROCEDURE	IPACK block	IPACK block was realized after spinal anesthesia with 40 ml 0.2% ropivacaine and at the end of surgery , patients were given ACB with 20 ml 0.2% ropivacaine and continued with 4 ml/H saline for 48H

Timeline

• Start date: 2020-03-31
• Primary completion: 2022-03-30
• Completion: 2022-07-31
• First posted: 2020-03-04
• Last updated: 2024-02-13

Locations

1 site across 1 country: Tunisia