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Effect of two-level ESPB in Total 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 inflammatory response, opioid consumption, and opioid-related side effects.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| iPACK + ACB | Active Comparator | Ultrasound-guided iPACK +ACB |
|
| Two-Level ESPB | Active Comparator | Bi-level Ultrasound-guided ESPB et the L1 and S1 |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| 2 x 20 ml of Ropivacaine 0.2% Injectable Solution | Drug | 2 x 20ml 0.2% Ropivacaine - ultrasound-guided iPACK + ACB |
|
| Measure | Description | Time Frame |
|---|---|---|
| Total Opioid Consumption | Total opioid consumption after surgery - within 48 hours after surgery | 48 hours after surgery |
| Measure | Description | Time Frame |
|---|---|---|
| Time to first rescue opioid analgesia | Time after surgery when the patient needs opiate for the first time | 48 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) |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Malgorzata Reysner, M.D. 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 |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 41902932 | Derived | Pietraszek P, Reysner T, Gola W, Kluzik A, Perek A, Marszalek-Buko J, Reysner M. Combined iPACK and adductor canal block versus two-level erector spinae plane block in elderly patients undergoing total knee arthroplasty: a randomized, triple-blinded clinical trial. Arch Orthop Trauma Surg. 2026 Mar 28;146(1):128. doi: 10.1007/s00402-026-06247-x. |
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Detailed data sharing plan to be defined
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Data will be shared following the trial completion
Eligible researchers
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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 |
| ID | Term |
|---|---|
| D000813 | Anilides |
| D000577 | Amides |
| D009930 | Organic Chemicals |
| D000814 | Aniline Compounds |
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| 2 x 20ml of Ropivacaine 0.2% Injectable Solution | Drug | 2 x 20ml 0.2% ropivacaine - ultrasound-guided ESPB at the L1 and S1 level |
|
|
| 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) | 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) | 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) | 48 hours after surgery |
| NLR | neutrophil-to-lymphocyte ratio | 24 hours after surgery |
| NLR | neutrophil-to-lymphocyte ratio | 48 hours after surgery |
| PLR | platelet-to-lymphocyte ratio | 24 hours after surgery |
| PLR | 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 | 4 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 | 8 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 | 12 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 | 24 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 | 48 hours after surgery |
| D012216 |
| Rheumatic Diseases |
| D000588 |
| Amines |