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A lot of patient have posterior knee pain after ACL reconstruction despite saphenous nerve block. Recently a new block has been described, know as IPACK block (interspace between the popliteal artery and the capsule of the posterior knee). The objective of this randomized controlled double-blinded trial is to assess whether a combined saphenous nerve block with IPACK block is more effective for the postoperative pain than a local infiltration analgesia.
The saphenous nerve and the iPACK will be performed after general anaesthesia induction and before the surgery under ultrasound-guidance.
The local infiltration analgesia will be performed by the surgeon during the surgery.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| IPACK block | Experimental | Saphenous nerve block and IPACK block by anesthetist under ultrasound guidance. |
|
| Local infiltration analgesia | Active Comparator | Periarticular infiltration by surgeon |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Ropivacaine injection | Drug | Saphenous nerve block with 20ml of ropivacaine 0.5% and IPACK block with 30ml of ropivacaine 0.2% (total dose of 160 mg). |
|
| Measure | Description | Time Frame |
|---|---|---|
| Total morphine consumption (mg) | 24 hours postoperatively |
| Measure | Description | Time Frame |
|---|---|---|
| Total morphine consumption (mg) | 2 hours, 48 hours and 72 hours postoperatively | |
| Pain scores (numeric rating scale, 0-10) at rest and on movement | 0= no pain, 10=the worst pain imaginable | 2hours, 24hours, 48hours and 72hours postoperatively |
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Inclusion Criteria:
Exclusion Criteria:
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Department of Anesthesia, Centre Hospitalier Universitaire Vaudois and University of Lausanne | Lausanne | Canton of Vaud | 1011 | Switzerland |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 34039734 | Derived | Martin R, Kirkham KR, Ngo THN, Gonvers E, Lambert J, Albrecht E. Combination of femoral triangle block and infiltration between the popliteal artery and the capsule of the posterior knee (iPACK) versus local infiltration analgesia for analgesia after anterior cruciate ligament reconstruction: a randomized controlled triple-blinded trial. Reg Anesth Pain Med. 2021 Sep;46(9):763-768. doi: 10.1136/rapm-2021-102631. Epub 2021 May 26. |
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| Ropivacaine injection | Drug | Periarticular infiltration of 80 ml ropivacaine 0.2% (total dose of 160mg). |
|
| Rate of postoperative nausea and vomiting | Yes/No | 2hours, 24hours, 48hours and 72hours postoperatively |
| Rate of antiemetic consumption | Yes/No | 2hours, 24hours, 48hours and 72hours postoperatively |
| Rate of pruritus | Yes/No | 2hours, 24hours, 48hours and 72hours postoperatively |
| Active flexion | Flexion of the knee by the patient measured in degrees | 24hours, 48hours and 72hours postoperatively |
| Quadriceps muscle strength (numeric scale, 1-5) | 1=no contraction, 5=normal strength | 24hours, 48hours and 72hours postoperatively |
| Distance walked (meters) | 24 hours, 48hours and 72hours postoperatively |
| Anterior Cruciate Ligament - Return to Sport after Injury survey | 4 and 8 postoperative months |
| International Knee Documentation Committee score | 4 and 8 postoperative months |
| ID | Term |
|---|---|
| D010149 | Pain, Postoperative |
| D000070598 | Anterior Cruciate Ligament Injuries |
| ID | Term |
|---|---|
| D011183 | Postoperative Complications |
| D010335 | Pathologic Processes |
| D013568 | Pathological Conditions, Signs and Symptoms |
| D010146 | Pain |
| D009461 | Neurologic Manifestations |
| D012816 | Signs and Symptoms |
| D007718 | Knee Injuries |
| D007869 | Leg Injuries |
| D014947 | Wounds and Injuries |
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| ID | Term |
|---|---|
| D000077212 | Ropivacaine |
| ID | Term |
|---|---|
| D000813 | Anilides |
| D000577 | Amides |
| D009930 | Organic Chemicals |
| D000814 | Aniline Compounds |
| D000588 | Amines |
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