Impact of Dexamethasone Route on Pain and Inflammation in iPACK With ACB for Knee Arthroplasty

Route of Dexamethasone Administration in iPACK and ACB for Total Knee Replacement: A Randomized Trial

"The Effect of Dexamethasone Administration Route on Pain and Inflammatory Response in iPACK With ACB for Total Knee Arthroplasty" - written in plain language according to ClinicalTrials.gov standards:

The goal of this clinical trial is to learn how the route of dexamethasone administration (either through the vein or nerve block) affects pain and inflammation in people having total knee replacement surgery. All participants will receive two types of nerve blocks before surgery: an iPACK block and an adductor canal block (ACB), which help control pain after the operation.

The main questions the study aims to answer are:

Does injecting dexamethasone into the nerve block reduce pain more effectively than giving it by vein? Which method leads to a lower inflammatory response after surgery? Researchers will compare the two groups to see which route offers better pain relief and less swelling after knee surgery.

Participants will:

Be randomly assigned to receive dexamethasone either in the nerve block or by IV Receive standard care for total knee replacement Rate their pain and have blood tests after surgery to measure inflammation

Inclusion Criteria:

• patients scheduled for total knee arthroplasty
• patients aged >65 and <100 years
• patients can provide informed consent
• patients can reliably report symptoms to the research team

Exclusion Criteria:

• inability to provide first-party consent due to cognitive impairment or a
• language barrier
• infection at the site of the regional block,
• coagulation disorders,
• immunodeficiency,
• American Society of Anesthesiologists (ASA) physical status of IV or higher,
• history of regular steroid medication.