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Comparison of adductor canal block and IPACK block (interspace between the popliteal artery and the capsule of the posterior knee) with adductor canal block alone after total knee arthroplasty: a prospective control trial on pain and knee function in immediate postoperative period.

作者信息

Sankineani S R, Reddy A R C, Eachempati Krishna Kiran, Jangale Ajit, Gurava Reddy A V

机构信息

Department of Orthopaedics, Sunshine Hospital, P.G.Road, Secunderabad, Telangana, India.

Department of Anaesthesia, Mediciti Institute of Medical Sciences, Medchal, Hyderabad, India.

出版信息

Eur J Orthop Surg Traumatol. 2018 Oct;28(7):1391-1395. doi: 10.1007/s00590-018-2218-7. Epub 2018 May 2.


DOI:10.1007/s00590-018-2218-7
PMID:29721648
Abstract

BACKGROUND: Adductor canal block (ACB) is a peripheral nerve blockade technique that provides good pain control in patients undergoing total knee arthroplasty which however does not relieve posterior knee pain. The recent technique of an ultrasound-guided local anesthetic infiltration of the interspace between popliteal artery and the capsule of posterior knee (IPACK) has shown promising results in providing significant posterior knee analgesia without affecting the motor nerves. MATERIALS AND METHODS: A prospective study was conducted from September 2016 to March 2017 in a total of 120 patients undergoing unilateral total knee arthroplasty. The initial 60 consecutive patients received ACB + IPACK (Group 1, n = 60), and the subsequent 60 patients received ACB alone (Group 2, n = 60). All patients were evaluated with VAS score for pain recorded at 8 h, postoperative day (POD) 1 and POD 2 after the surgery. The secondary outcome measures assessed were the range of movement (ROM) and ambulation distance. RESULTS: VAS score showed significantly (p < 0.005) better values in ACB + IPACK group compared to the ACB group. The mean ROM of knee and ambulation distance also showed significantly better values in ACB + IPACK group compared to the ACB group. CONCLUSION: ACB + IPACK is a promising technique that offers improved pain management in the immediate postoperative period without affecting the motor function around the knee joint resulting in better ROM and ambulation compared to ACB alone.

摘要

相似文献

[1]
Comparison of adductor canal block and IPACK block (interspace between the popliteal artery and the capsule of the posterior knee) with adductor canal block alone after total knee arthroplasty: a prospective control trial on pain and knee function in immediate postoperative period.

Eur J Orthop Surg Traumatol. 2018-10

[2]
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[3]
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[4]
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[5]
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[7]
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[8]
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[9]
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引用本文的文献

[1]
The effect of adding dexamethasone to adductor block and IPACK block on acute postoperative, rebound, and chronic pain following knee arthroplasty-1-year follow-up.

Front Med (Lausanne). 2025-4-29

[2]
Management of Postoperative Pain Following Primary Total Knee Arthroplasty: A Level I Evidence-Based Bayesian Network Meta-Analysis.

Pharmaceuticals (Basel). 2025-4-9

[3]
No superior method for analgesia after total knee arthroplasty: randomised controlled comparison of adductor canal block combined with iPACK block versus posterior capsule block.

Arch Orthop Trauma Surg. 2025-4-5

[4]
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J Hip Preserv Surg. 2024-2-5

[5]
Analgesic Effect of Intermittent Multiple IPACK Block Combined with ACB in Patients with Flexion Contracture Knee Arthritis Undergoing Total Knee Arthroplasty.

J Knee Surg. 2025-5

[6]
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J Orthop Surg Res. 2024-12-19

[7]
Association of iPACK block and adductor canal block in dogs undergoing the tibial plateau leveling osteotomy technique: Report of 4 cases.

Braz J Vet Med. 2024-6-5

[8]
Total Knee Arthroplasty With and Without Schedule II Opioids: A Randomized, Double-Blinded, Placebo-Controlled Trial.

Cureus. 2024-3-14

[9]
A cadaveric study investigating the spread of injectate following an interspace between the popliteal artery and the capsule of the posterior knee block in a neonatal sample: a pilot study.

Anat Cell Biol. 2024-6-30

[10]
IPACK Block Efficacy for Acute Pain Management after Total Knee Replacement: A Review.

Curr Pain Headache Rep. 2024-7

本文引用的文献

[1]
Anterior vs Posterior Periarticular Multimodal Drug Injections: A Randomized, Controlled Trial in Simultaneous Bilateral Total Knee Arthroplasty.

J Arthroplasty. 2017-7

[2]
Searching for the Optimal Pain Management Technique after Knee Arthroplasty: Analgesia Is Just the Tip of the Iceberg.

Anesthesiology. 2017-5

[3]
Pain Management Modalities after Total Knee Arthroplasty: A Network Meta-analysis of 170 Randomized Controlled Trials.

Anesthesiology. 2017-5

[4]
Anesthetic and Analgesic Management for Outpatient Knee Arthroplasty.

Curr Pain Headache Rep. 2017-5

[5]
Adductor canal block for knee surgical procedures: review article.

J Clin Anesth. 2016-12

[6]
Single-Dose Adductor Canal Block With Local Infiltrative Analgesia Compared With Local Infiltrate Analgesia After Total Knee Arthroplasty: A Randomized, Double-Blind, Placebo-Controlled Trial.

Reg Anesth Pain Med. 2016

[7]
Intermittent versus continuous sciatic block combined with femoral block for patients undergoing knee arthroplasty. A randomized controlled trial.

Int Orthop. 2016-9

[8]
Analgesic efficacy and quadriceps strength of adductor canal block versus femoral nerve block following total knee arthroplasty.

Knee Surg Sports Traumatol Arthrosc. 2016-8

[9]
Adductor canal block provides better performance after total knee arthroplasty compared with femoral nerve block: a systematic review and meta-analysis.

Int Orthop. 2016-5

[10]
Continuous ultrasound-guided adductor canal block for total knee arthroplasty: a randomized, double-blind trial.

Anesth Analg. 2014-6

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