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A comparison of two pain control methods - the combination of Adductor Canal Block (ACB)/Infiltration of the interspace between the popliteal artery and the capsule of the posterior knee (IPACK) versus the Periarticular Injection (PAI)/ Infiltration of the interspace between the popliteal artery and the capsule of the posterior knee (IPACK) - in patients undergoing total knee arthroplasty. dexketoprofen and paracetamol will be added to both groups and multimodal analgesia will be applied. Primary outcome is NRS pain scores with ambulation on postoperative day one (24 hours post-block administration).
Postoperative pain after total knee arthroplasty is serious and difficult to management. Multimodal analgesia recommended for the pain management. For these reasons, we planned a study involving two multimodal analgesia regimens. Patients who will undergo total knee arthroplasty will receive preemptive oral analgesic (dexketofrofen) 1 hour before the operation. Surgery will be initiated after spinal anesthesia is applied to the patients. Two pain control methods - the combination of Adductor Canal Block (ACB)/Infiltration of the interspace between the popliteal artery and the capsule of the posterior knee (IPACK) versus the Periarticular Injection (PAI)/ IPACK- will be applied at the end of the surgery. dexketoprofenand paracetamol will be added to both groups and multimodal analgesia will be applied. Primary outcome is NRS pain scores with ambulation on postoperative day one (24 hours post-block administration).
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Peri-Articular Injections and IPACK | Experimental | Spinal anesthetic with 2,5 ml 0,5% heavy bupivacaine At the end of surgery; PAI: 30 ml 0,025% bupivacaine and IPACK: 20 ml 0,025% bupivacaine |
|
| Adductor Canal Block, and IPACK | Active Comparator | Spinal anesthetic with 2,5 ml 0,5% heavy bupivacaine At the end of surgery; ADD: 20 ml 0,025% bupivacaine and IPACK: 20 ml 0,025% bupivacaine |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Dexketoprofen Trometamol | Drug | Drug: Dexketoprofen Trometamol oral tablet |
|
| Measure | Description | Time Frame |
|---|---|---|
| NRS Pain Scores | NRS Pain scores with ambulation 24 hours post block administration.All patients' postoperative pain numerical rating scale (NRS-numeric rating scale; 0 = absence of pain, 10 = unbearable pain) will be recorded in both groups. | 24 hours post block administration |
| Measure | Description | Time Frame |
|---|---|---|
| NRS at Rest and with movement | NRS at rest and with movement at different intervals. All patients' postoperative pain numerical rating scale (NRS-numeric rating scale; 0 = absence of pain, 10 = unbearable pain) will be recorded in both groups. | 24 hours on Post-Operative Day 1 |
| Patient Satisfaction with Pain Control using the likert scale |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| ilkay MD Baran akkus, MD | Contact | 0905323852642 | 0903125902000 | ilkayb@hotmail.com |
| Name | Affiliation | Role |
|---|---|---|
| Ilkay MD Baran Akkuş, MD | Diskapi Yildirim Beyazit Training Education Hospital | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Diskapi Yildirim Beyazit Training Research Hospital | Recruiting | Ankara | Altındag | 06450 | Turkey (Türkiye) |
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| ID | Term |
|---|---|
| C118296 | dexketoprofen trometamol |
| D000775 | Anesthesia, Spinal |
| ID | Term |
|---|---|
| D000765 | Anesthesia, Conduction |
| D000758 | Anesthesia |
| D000760 | Anesthesia and Analgesia |
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Power analysis will be done after a pilot study. Number of patient may vary.
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| spinal anesthesia | Other | Drug: heavy bupivacaine 2,5 ml 0,5% |
|
| IPACK | Other | Drug: bupivacaine 20 ml 0,025% |
|
| PAI | Other | Drug: bupivacaine 30 ml 0,025% |
|
| Adductor canal block | Other | Drug: bupivacaine 20 ml 0,025% |
|
Satisfaction with Pain control at different intervals. 1-5 (according to patient satisfaction) |
| Post-Operative 24 hours |