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One of the most common injuries to the knee is an anterior cruciate ligament (ACL) sprain or tear due to trauma ACL damage is crippling and often requires repair with an arthroscopic method, which is an outpatient surgery. Nevertheless, patients experience severe postoperative pain on the first day after the ACL reconstruction.Efficient postsurgery pain management is an important part of patient recovery that is also crucial for their satisfaction.
The optimum role of peripheral nerve blocks in ACL reconstruction continue to be debated as a component of multi-modal analgesia . As such ,an ideal block for ACLR would target sensation but not motor function,have minimal complication risk,and be easily reproducible The genicular nerves include branches from the femoral, common peroneal, saphenous, tibial, and obturator nerves which innervate the knee capsule . The superolateral, superomedial, and inferomedial On the other hand, the interspace between the Popliteal Artery and Capsule of the Knee (IPACK) block provides analgesia on the posterior knee joint, and the application of a genicular or IPACK block has been be associated with promising outcomes following the ACLR surgery
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Control group | No Intervention | did not receive any block just spinal anathesia. | |
| Genicular nerve block | Active Comparator | patients who receive Genicular nerve block with spinal anathesia . |
|
| IPACK block | Active Comparator | patients who receive IPACK block with spinal anathesia. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Genicular nerve block | Procedure | patients who receive Genicular nerve block with spinal anathesia . |
|
| Measure | Description | Time Frame |
|---|---|---|
| VAS score | Measuring pain intensity regarding mean visual analogue score (VAS score ) ranging from 0 (no pain) to 10 (the worst imaginable pain. | 48 hour |
| Measure | Description | Time Frame |
|---|---|---|
| Ambulatory score | Ambulatory score from ( 0 to 2) (score of 0) is assigned if the activity cannot be performed despite substantial help (score of 1 )is assigned if the activity is performed using personal physical support. (score of 2) is assigned if the activity is performed independently. | Within 48 hour |
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Inclusion Criteria:
- Patient age from 18 to 45 years old Patient status ASA I - II Patient body mass index (BMI) <40 kg/m2
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Mariana AbdElsayed Mansour | Contact | 01222960009 | MD | mrmrsyk4@gmail.com |
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Benisuef University Hospital | Recruiting | Benisuef | Egypt |
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| ID | Term |
|---|---|
| D010149 | Pain, Postoperative |
| ID | Term |
|---|---|
| D011183 | Postoperative Complications |
| D010335 | Pathologic Processes |
| D013568 | Pathological Conditions, Signs and Symptoms |
| D010146 | Pain |
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| Time of first rescue analgesia |
the time to ask for the first post operative analgesia |
| within 24 hour |
| Total opioid consumption post operative | Total opioid consumption post operative | Within 24 hour |
| Incidence of occurrence of systemic toxicity | ( hypotension ,arrthymias, bradycardia, cardiac arrest, oral numbness and convulsions | Within 24 hour |
| The length of hospital stay . | The length of hospital stay . | within one week |
| D009461 | Neurologic Manifestations |
| D012816 | Signs and Symptoms |