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外科医生主导的腘动脉与膝关节囊之间关节镜下浸润（IPACK）阻滞：技术描述

Surgeon-Directed Arthroscopic Infiltration Between the Popliteal Artery and Capsule of the Knee (IPACK) Block: Technical Description.

作者信息

Shroff Jeffrey B, Hanna Philip, Edgar Cory M

机构信息

University of Connecticut Health, Farmington, Connecticut, U.S.A.

Department of Orthopedic Surgery, Farmington, Connecticut, U.S.A.

出版信息

Arthrosc Tech. 2023 Mar 23;12(4):e531-e536. doi: 10.1016/j.eats.2022.12.005. eCollection 2023 Apr.

DOI:10.1016/j.eats.2022.12.005
PMID:37138697
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10150044/
Abstract

Advances in regional anesthesia techniques for knee surgery have led to drastic improvements in postoperative pain control and have reduced reliance on perioperative opioid analgesics. The infiltration between the popliteal artery and capsule of the knee (IPACK) block has been a useful tool for providing posterior knee analgesia as an adjuvant to traditional femoral or adductor canal blocks in knee surgery. We present a simple and reproducible technique for the arthroscopic administration of this block.

摘要

膝关节手术区域麻醉技术的进展已使术后疼痛控制得到显著改善，并减少了对围手术期阿片类镇痛药的依赖。腘动脉与膝关节囊之间浸润阻滞（IPACK阻滞）作为膝关节手术中传统股神经阻滞或收肌管阻滞的辅助手段，一直是提供膝关节后方镇痛的有效方法。我们介绍一种用于关节镜下实施该阻滞的简单且可重复的技术。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5b47/10150044/73cfe9bb84f1/gr4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5b47/10150044/eebdae4e2b31/gr1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5b47/10150044/27220f76dfbd/gr2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5b47/10150044/ac38bd70fd7d/gr3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5b47/10150044/73cfe9bb84f1/gr4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5b47/10150044/eebdae4e2b31/gr1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5b47/10150044/27220f76dfbd/gr2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5b47/10150044/ac38bd70fd7d/gr3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5b47/10150044/73cfe9bb84f1/gr4.jpg

相似文献

1
Surgeon-Directed Arthroscopic Infiltration Between the Popliteal Artery and Capsule of the Knee (IPACK) Block: Technical Description.外科医生主导的腘动脉与膝关节囊之间关节镜下浸润（IPACK）阻滞：技术描述
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2
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Implementation of the IPACK (Infiltration between the Popliteal Artery and Capsule of the Knee) block into a multimodal analgesic pathway for total knee replacement.将 IPACK（膝后囊和腘动脉之间的渗透）阻滞技术应用于全膝关节置换的多模式镇痛方案。
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引用本文的文献

1
Does Adding an IPACK Block to the Suprainguinal Fascia Iliaca Block Improve the Quality of Analgesia in Patients Undergoing Knee Arthroplasty under Spinal Anesthesia? A Retrospective Cohort Study.在脊髓麻醉下进行膝关节置换术的患者中，在股外侧肌筋膜间隙阻滞中添加 IPACK 阻滞是否能提高镇痛质量？一项回顾性队列研究。
Medicina (Kaunas). 2023 Oct 20;59(10):1870. doi: 10.3390/medicina59101870.

本文引用的文献

1
iPACK block (local anesthetic infiltration of the interspace between the popliteal artery and the posterior knee capsule) added to the adductor canal blocks versus the adductor canal blocks in the pain management after total knee arthroplasty: a systematic review and meta-analysis.iPACK 阻滞（即隐动脉和后膝关节囊之间的间隙局部麻醉浸润）联合收肌管阻滞与单纯收肌管阻滞用于全膝关节置换术后疼痛管理的效果比较：一项系统评价和荟萃分析。
J Orthop Surg Res. 2022 Aug 12;17(1):387. doi: 10.1186/s13018-022-03272-5.
2
Ultrasound-Guided Local Anesthetic Infiltration Between the Popliteal Artery and the Capsule of the Posterior Knee (IPACK) Block for Primary Total Knee Arthroplasty: A Systematic Review of Randomized Controlled Trials.超声引导下腘动脉与后膝关节囊之间局部麻醉药浸润（IPACK）阻滞用于初次全膝关节置换术：随机对照试验的系统评价
Local Reg Anesth. 2021 May 12;14:85-98. doi: 10.2147/LRA.S303827. eCollection 2021.
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Reg Anesth Pain Med. 2021 Sep;46(9):784-805. doi: 10.1136/rapm-2021-102681. Epub 2021 May 14.
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Addition of Infiltration Between the Popliteal Artery and the Capsule of the Posterior Knee and Adductor Canal Block to Periarticular Injection Enhances Postoperative Pain Control in Total Knee Arthroplasty: A Randomized Controlled Trial.在膝关节后囊和收肌管的腘动脉周围浸润与关节周围注射联合应用可增强全膝关节置换术后的疼痛控制：一项随机对照试验。
Anesth Analg. 2019 Aug;129(2):526-535. doi: 10.1213/ANE.0000000000003794.
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Eur J Orthop Surg Traumatol. 2018 Oct;28(7):1391-1395. doi: 10.1007/s00590-018-2218-7. Epub 2018 May 2.
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Posteromedial Meniscocapsular Lesions Increase Tibiofemoral Joint Laxity With Anterior Cruciate Ligament Deficiency, and Their Repair Reduces Laxity.后内侧半月板关节囊损伤会增加前交叉韧带损伤时的胫股关节松弛度，而对其进行修复可减少松弛度。
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Arthroscopic prevalence of ramp lesion in 868 patients with anterior cruciate ligament injury.868 例前交叉韧带损伤患者的关节镜 Ramp 病变患病率。
Am J Sports Med. 2011 Apr;39(4):832-7. doi: 10.1177/0363546510388933. Epub 2011 Jan 10.
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Comparison of femoral nerve block and fascia iliaca block for analgesia following reconstructive knee surgery in adolescents.青少年重建膝关节手术后股神经阻滞与股外侧肌筋膜阻滞的镇痛效果比较。
J Clin Anesth. 2010 Jun;22(4):256-9. doi: 10.1016/j.jclinane.2009.08.006.
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Postoperative pain management after anterior cruciate ligament reconstruction.前交叉韧带重建术后的疼痛管理
J Knee Surg. 2004 Jan;17(1):18-23. doi: 10.1055/s-0030-1247142.
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Comparison of oral ketorolac and hydrocodone for pain relief after anterior cruciate ligament reconstruction.口服酮咯酸与氢可酮在前交叉韧带重建术后止痛效果的比较。
Arthroscopy. 1998 Sep;14(6):605-12. doi: 10.1016/s0749-8063(98)70057-x.