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This randomized, double-blinded, placebo-controlled trial sought to evaluate the efficacy of the iPACK block with Adductor Canal Block on postoperative pain, functional recovery and NLR and PLR levels.
The Interspace between the popliteal artery and capsule of the posterior knee, or iPACK block, together with the Adductor Canal block (ACB), has been described and shows promise in providing analgesia to the knee joint. However, the effect of these two blocks on postoperative pain levels, functional recovery, and stress response is uncertain. This study compares a preoperative iPACK and ACB block to Sham blocks before total knee arthroplasty under spinal anesthesia.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| iPACK block+ABC block | Active Comparator | Patients received a preoperative ultrasound-guided iPACK block with 20 mL of 0.25% ropivacaine and an Adductor Canal block with 20mL 0.25% ropivacaine. |
|
| Sham blocks | Active Comparator | Patients received a preoperative ultrasound-guided iPACK block with 20 mL of 0.9% normal saline and an Adductor Canal block with 20mL 0.9% normal saline. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Ropivacaine 0.2% Injectable Solution | Drug | 20 mL 0.5% ropivacaine was injected into the PENG block 20 mL 0.5% ropivacaine was injected into the Adductor Canal block |
|
| Measure | Description | Time Frame |
|---|---|---|
| postoperative Numeric Pain Rating Scale | Numeric Pain Rating Scale. The 11-point numeric scale ranges from '0' representing one pain extreme (e.g. "no pain") to '10' representing the other pain extreme (e.g. "pain as bad as you can imagine" or "worst pain imaginable") | 24 hours after surgery |
| postoperative Numeric Pain Rating Scale et rest | Numeric Pain Rating Scale. The 11-point numeric scale ranges from '0' representing one pain extreme (e.g. "no pain") to '10' representing the other pain extreme (e.g. "pain as bad as you can imagine" or "worst pain imaginable") | 48 hours after surgery |
| postoperative Numeric Pain Rating Scale et rest | Numeric Pain Rating Scale. The 11-point numeric scale ranges from '0' representing one pain extreme (e.g. "no pain") to '10' representing the other pain extreme (e.g. "pain as bad as you can imagine" or "worst pain imaginable") | 72 hours after surgery |
| postoperative Numeric Pain Rating Scale et rest | Numeric Pain Rating Scale. The 11-point numeric scale ranges from '0' representing one pain extreme (e.g. "no pain") to '10' representing the other pain extreme (e.g. "pain as bad as you can imagine" or "worst pain imaginable") | 96 hours after surgery |
| postoperative Numeric Pain Rating Scale during active flexion | Numeric Pain Rating Scale. The 11-point numeric scale ranges from '0' representing one pain extreme (e.g. "no pain") to '10' representing the other pain extreme (e.g. "pain as bad as you can imagine" or "worst pain imaginable") | 48 hours after surgery |
| postoperative Numeric Pain Rating Scale during active flexion |
| Measure | Description | Time Frame |
|---|---|---|
| Postoperative opioid consumption | milligrams of intravenous morphine equivalents | 96 hours after surgery |
| Neutrophil-to-lymphocyte ratio | Neutrophil-to-lymphocyte ratio |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Zbigniew Żaba, Ph.D. | Department of Emergency Medicine Clinic | Study Chair |
| Malgorzata Domagalska, Ph.D. | Department of Palliative Medicine, University of Medical Sciences, Poznań, Poland | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Poznan University of Medical Sciences | Poznan | Poznań | 61-701 | Poland |
The data presented in this study are available on request from the corresponding author.
December 2024
The data presented in this study are available on request from the corresponding author.
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| ID | Term |
|---|---|
| D020370 | Osteoarthritis, Knee |
| D000377 | Agnosia |
| ID | Term |
|---|---|
| D010003 | Osteoarthritis |
| D001168 | Arthritis |
| D007592 | Joint Diseases |
| D009140 | Musculoskeletal Diseases |
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| ID | Term |
|---|---|
| D000077212 | Ropivacaine |
| D012965 | Sodium Chloride |
| D000077330 | Saline Solution |
| ID | Term |
|---|---|
| D000813 | Anilides |
| D000577 | Amides |
| D009930 | Organic Chemicals |
| D000814 | Aniline Compounds |
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randomized, double-blind, placebo-controlled
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|
| 0.9%sodium chloride | Drug | 20 mL 0.9% sodium chloride was injected into the PENG block 20 mL 0.5% sodium chloride was injected into the Adductor Canal block |
|
|
Numeric Pain Rating Scale. The 11-point numeric scale ranges from '0' representing one pain extreme (e.g. "no pain") to '10' representing the other pain extreme (e.g. "pain as bad as you can imagine" or "worst pain imaginable") |
| 72 hours after surgery |
| postoperative Numeric Pain Rating Scale during active flexion | Numeric Pain Rating Scale. The 11-point numeric scale ranges from '0' representing one pain extreme (e.g. "no pain") to '10' representing the other pain extreme (e.g. "pain as bad as you can imagine" or "worst pain imaginable") | 96 hours after surgery |
| 12 hours after surgery |
| Neutrophil-to-lymphocyte ratio | Neutrophil-to-lymphocyte ratio | 24 hours after surgery |
| Platelet-to-lymphocyte ratio | Platelet-to-lymphocyte ratio | 12 hours after surgery |
| Platelet-to-lymphocyte ratio | Platelet-to-lymphocyte ratio | 24 hours after surgery |
| Time to first opioid administration | Hours to first administration of an intravenous opioid drug | 96 hours postoperatively |
| D012216 |
| Rheumatic Diseases |
| D010468 | Perceptual Disorders |
| D019954 | Neurobehavioral Manifestations |
| D009461 | Neurologic Manifestations |
| D009422 | Nervous System Diseases |
| D012816 | Signs and Symptoms |
| D013568 | Pathological Conditions, Signs and Symptoms |
| D000588 |
| Amines |
| D002712 | Chlorides |
| D006851 | Hydrochloric Acid |
| D017606 | Chlorine Compounds |
| D007287 | Inorganic Chemicals |
| D017670 | Sodium Compounds |
| D000077324 | Crystalloid Solutions |
| D007552 | Isotonic Solutions |
| D012996 | Solutions |
| D004364 | Pharmaceutical Preparations |