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Effect of iPACK block with Adductor Canal Block and ESPB on pain management, and NLR and PLR following knee arthroplasty
Knee arthroplasty is one of the most common orthopaedic procedures, especially in elderly patients, due to the deformation of joints. Patients may complain of severe pain due to surgical trauma and prostheses. Regional anaesthesia methods may be performed to reduce the surgery's induced stress response, opioid consumption, and opioid-related side effects.
In recent years, the influence of regional anesthesiology on reducing the inflammatory response after surgical procedures has been emphasised. However, very few studies have evaluated the effect of various methods of anaesthesia on the NLR and PLR.
This is the first study to investigate the effect of regional anaesthesia on the pain managementonse expres and stress respsed by the NLR and PLR in patients undergoing knee replacement surgery.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| iPACK + ACB | Active Comparator | spinal anesthesia + ultrasound guided iPACK (20ml 0,2% ropivacaine) with ACB (10ml 0.5% ropivacaine) |
|
| Erectro Spinae Plane Block | Active Comparator | spinal anesthesia + ultrasound guided ESPBk - 20ml 0,2% ropivacaine |
|
| Control group | Placebo Comparator | Only spinal anesthesia - No peripheral nerve block |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Ropivacaine 0.2% Injectable Solution | Drug | iPACK block + Adductor Canal Block |
|
| Measure | Description | Time Frame |
|---|---|---|
| Opioid consumption | Total opiate consumption after surgery | 48 hours after surgery |
| Measure | Description | Time Frame |
|---|---|---|
| Time to first rescue opiate analgesia | Time after surgery when the patient needs opiate for the first time | 48 hours after procedure |
| Numerical Rating Scale [range 0:10] | Postoperative pain assessment will be performed using the NRS score (0 = no pain, 10 = the most severe pain felt) |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Malgorzata Domagalska, Ph.D. | Contact | 608762068 | m.domagalska@ump.edu.pl | |
| Małgorzata Domagalska, Ph.D. | Contact | 61 873 83 03 | m.domagalska@ump.edu.pl |
| Name | Affiliation | Role |
|---|---|---|
| Łukasz Łapaj, Ph.D. | Poznań University of Medical Sciences | Study Chair |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Poznan University of Medical Sciences | Poznan | Poznań | 61-701 | Poland |
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6 month after study completion
from the corresponding author on the resonable request
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| ID | Term |
|---|---|
| D020370 | Osteoarthritis, Knee |
| ID | Term |
|---|---|
| D010003 | Osteoarthritis |
| D001168 | Arthritis |
| D007592 | Joint Diseases |
| D009140 | Musculoskeletal Diseases |
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| ID | Term |
|---|---|
| D000077212 | Ropivacaine |
| D035061 | Control Groups |
| ID | Term |
|---|---|
| D000813 | Anilides |
| D000577 | Amides |
| D009930 | Organic Chemicals |
| D000814 | Aniline Compounds |
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| Ropivacaine 0.2% Injectable Solution | Drug | Erector Spinae Plane Block |
|
|
| control group | Drug | only spinal anesthesia |
|
|
| Time Frame: 4 hours after surgery |
| Numerical Rating Scale [range 0:10] | Postoperative pain assessment will be performed using the NRS score (0 = no pain, 10 = the most severe pain felt) | Time Frame: 8 hours after surgery |
| Numerical Rating Scale [range 0:10] | Postoperative pain assessment will be performed using the NRS score (0 = no pain, 10 = the most severe pain felt) | Time Frame: 12 hours after surgery |
| Numerical Rating Scale [range 0:10] | Postoperative pain assessment will be performed using the NRS score (0 = no pain, 10 = the most severe pain felt) | Time Frame: 16 hours after surgery |
| Numerical Rating Scale [range 0:10] | Postoperative pain assessment will be performed using the NRS score (0 = no pain, 10 = the most severe pain felt) | Time Frame: 20 hours after surgery |
| Numerical Rating Scale [range 0:10] | Postoperative pain assessment will be performed using the NRS score (0 = no pain, 10 = the most severe pain felt) | Time Frame: 24 hours after surgery |
| Numerical Rating Scale [range 0:10] | Postoperative pain assessment will be performed using the NRS score (0 = no pain, 10 = the most severe pain felt) | Time Frame: 36 hours after surgery |
| Numerical Rating Scale [range 0:10] | Postoperative pain assessment will be performed using the NRS score (0 = no pain, 10 = the most severe pain felt) | Time Frame: 48 hours after surgery |
| Neutrophil-to-lymphocyte ratio | Neutrophil-to-lymphocyte ratio | 24 hours after surgery |
| Neutrophil-to-lymphocyte ratio | Neutrophil-to-lymphocyte ratio | 48 hours after surgery |
| Platelet-to-lymphocyte ratio | Platelet-to-lymphocyte ratio | 24 hours after surgery |
| Platelet-to-lymphocyte ratio | Platelet-to-lymphocyte ratio | 48 hours after surgery |
| Quadriceps muscle strength assessed using medical research council scale [range 0:5] | Quadriceps muscle strength (knee extension and hip adduction) will be evaluated according to the medical research council muscle strength rating | Postoperative 24 hours period |
| D012216 |
| Rheumatic Diseases |
| D000588 |
| Amines |
| D015340 | Epidemiologic Research Design |
| D004812 | Epidemiologic Methods |
| D008919 | Investigative Techniques |
| D012107 | Research Design |
| D008722 | Methods |