Jason Ochroch 1 , Victor Qi 1 , Ignacio Badiola 1 , Taras Grosh 1 , Lu Cai 1 , Veena Graff 1 , Charles Nelson 2 , Craig Israelite 2 , Nabil M Elkassabany 3 Show Affiliations »
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BACKGROUND AND OBJECTIVES: Peripheral nerve blocks have been integrated into most multimodal analgesia protocols for total knee arthroplasty (TKA ). The adductor canal block (ACB ) has gained popularity because of its quadriceps muscle sparing. Similarly, local anesthetic injection between the popliteal artery and the posterior capsule of the knee, IPACK block , has been described to provide analgesia to the posterior capsule of the knee with motor-sparing qualities. This prospective randomized controlled trial aimed to assess the analgesic efficacy of adding the IPACK block to our current multimodal analgesic regimen, including the ACB, in patients undergoing primary TKA . METHODS: 119 patients were randomized to receive either an IPACK or a sham block in addition to multimodal analgesia and an ACB . We were set to assess pain in the back of the knee 6 hours after surgery. Other end points included quality of recovery after surgery, pain scores, opioid requirements, and functional measures . RESULTS: Patients who received the IPACK block had less pain in the back of the knee 6 hours after surgery when compared with the sham block: 21.7% vs 45.8%, p<0.01. There was marginal improvement in other pain measures in the first 24 hours after surgery. However, opioid requirements, quality of recovery and functional measures were similar between the two groups. CONCLUSION: The IPACK block reduced the incidence of posterior knee pain 6 hours postoperatively. © American Society of Regional Anesthesia & Pain Medicine 2020. No commercial re-use. See rights and permissions. Published by BMJ.
RCT Entities: Population
Interventions
Outcomes
BACKGROUND AND OBJECTIVES: Peripheral nerve blocks have been integrated into most multimodal analgesia protocols for total knee arthroplasty (TKA). The adductor canal block (ACB ) has gained popularity because of its quadriceps muscle sparing. Similarly, local anesthetic injection between the popliteal artery and the posterior capsule of the knee, IPACK block, has been described to provide analgesia to the posterior capsule of the knee with motor-sparing qualities. This prospective randomized controlled trial aimed to assess the analgesic efficacy of adding the IPACK block to our current multimodal analgesic regimen, including the ACB , in patients undergoing primary TKA. METHODS: 119 patients were randomized to receive either an IPACK or a sham block in addition to multimodal analgesia and an ACB . We were set to assess pain in the back of the knee 6 hours after surgery. Other end points included quality of recovery after surgery, pain scores, opioid requirements, and functional measures. RESULTS: Patients who received the IPACK block had less pain in the back of the knee 6 hours after surgery when compared with the sham block: 21.7% vs 45.8%, p<0.01. There was marginal improvement in other pain measures in the first 24 hours after surgery. However, opioid requirements, quality of recovery and functional measures were similar between the two groups. CONCLUSION: The IPACK block reduced the incidence of posterior knee pain 6 hours postoperatively. © American Society of Regional Anesthesia & Pain Medicine 2020. No commercial re-use. See rights and permissions. Published by BMJ.
Entities: Chemical
Disease
Species
Keywords:
analgesia; analgesics; anesthesia; health care; local; nerve block; opioid; outcome assessment
Year: 2020
PMID： 32868483 DOI： 10.1136/rapm-2020-101558
Source DB: PubMed Journal: Reg Anesth Pain Med ISSN： 1098-7339 Impact factor: 6.288