Department of Anesthesiology and Reanimation, Faculty of Medicine, Samsun Education and Research Hospital, Samsun University, Barış Bulvarı No. 199, 55090 Samsun, Turkey.
Department of Orthopedics and Traumatology, Samsun Education and Research Hospital, Barış Bulvarı No. 199, 55090 Samsun, Turkey.
Medicina (Kaunas). 2023 Oct 20;59(10):1870. doi: 10.3390/medicina59101870.
Total knee arthroplasty (TKA) is a commonly performed orthopedic procedure, and is often accompanied by significant postoperative pain. The supra-inguinal fascia iliaca block (SIFIB), similar to an anterior lumbar plexus block, is frequently used in hip surgeries. The interspace between the popliteal artery and capsule of the posterior knee (IPACK) block is a regional anesthesia technique that targets the posterior innervation of the knee capsule. This retrospective study aimed to compare the analgesic effects of SIFIB and SIFIB + IPACK on patients undergoing TKA under spinal anesthesia. This retrospective study revealed the data collected from a tertiary hospital. Patient data were gathered for individuals who underwent unilateral TKA under spinal anesthesia during the period between 1 January 2023 and 1 September 2023. Inclusion criteria comprised patients falling within ASA class I-III, those following a standardized perioperative analgesia regimen, and individuals receiving opioids via a patient-controlled analgesia device (PCA) as part of their postoperative pain management strategy. Patients were grouped as SIFIB and SIFIB + IPACK according to the performed regional anesthesia technique. In the study, the data of 88 patients in total, 61 in the SIFIB group and 27 in the IPACK group, were analyzed. The 24 h cumulative morphine consumption was similar in the SIFIB and SIFIB + IPACK groups (10.62 ± 6.58 mg vs. 12.55 ± 8.84 mg, respectively; : 0.258). The NRS scores of the groups were similar in all time frames. Our study reveals that combining IPACK with SIFIB in the multimodal analgesia plan does not provide additional benefits in terms of postoperative opioid consumption and pain scores in patients undergoing unilateral THA under spinal anesthesia.
全膝关节置换术（TKA）是一种常见的矫形手术，常伴有明显的术后疼痛。髂筋膜上阻滞（SIFIB）类似于前路腰椎丛阻滞，常用于髋关节手术。腘窝动脉与后膝关节囊间隙（IPACK）阻滞是一种针对膝关节囊后神经支配的区域麻醉技术。本回顾性研究旨在比较 SIFIB 和 SIFIB+IPACK 对接受椎管内麻醉下 TKA 的患者的镇痛效果。
本回顾性研究从一家三级医院收集数据。研究对象为 2023 年 1 月 1 日至 2023 年 9 月 1 日期间接受椎管内麻醉下单侧 TKA 的患者。纳入标准包括 ASA 分级 I-III 级患者、采用标准化围手术期镇痛方案的患者以及接受患者自控镇痛（PCA）装置中阿片类药物作为术后疼痛管理策略一部分的患者。根据所进行的区域麻醉技术，患者分为 SIFIB 和 SIFIB+IPACK 组。
本研究共分析了 88 例患者的数据，其中 SIFIB 组 61 例，IPACK 组 27 例。SIFIB 和 SIFIB+IPACK 组的 24 小时累积吗啡消耗量相似（分别为 10.62±6.58mg 和 12.55±8.84mg；：0.258）。两组在所有时间点的 NRS 评分均相似。
我们的研究表明，在多模式镇痛方案中，将 IPACK 与 SIFIB 联合使用并不能为接受椎管内麻醉下单侧 TKA 的患者提供额外的益处，无论是在术后阿片类药物消耗还是疼痛评分方面。
