Ignite Creation Date:
2024-10-26 @ 3:39 PM
Last Modification Date:
2024-10-26 @ 3:39 PM
Study NCT ID:
NCT06586840
Status:
RECRUITING
Last Update Posted:
None
First Post:
2024-08-01
Brief Title:
The Effect of Adding an IPACK Block to the Adductor Canal Block on Total Knee Arthroplasty Surgery
Sponsor:
None
Organization:
None
Study Overview
Official Title:
The Effect of Adding an IPACK Block to the Adductor Canal Block on Postoperative Pain and Hospital Stay in Patients Undergoing Total Knee Arthroplasty Surgery
Status:
RECRUITING
Status Verified Date:
2024-09
Last Known Status:
None
Delayed Posting:
No
If Stopped, Why?:
Not Stopped
Has Expanded Access:
No
If Expanded Access, NCT#:
N/A
Has Expanded Access, NCT# Status:
N/A
Acronym:
None
Brief Summary:
Total knee arthroplasty TKA is a frequently performed major orthopedic surgery where most patients experience severe postoperative pain Pain-related delays in patient mobilization can lead to thromboembolism deep vein thrombosis surgical site infection and increased risk of hospital-acquired infections due to prolonged hospital stay Optimal postoperative knee analgesia is crucial not only for patient comfort and satisfaction but also for accelerating mobilization functional recovery and discharge from the hospital To facilitate early ambulation and superior performance multimodal analgesia and motor-sparing blocks are increasingly utilized
Detailed Description:
In total knee arthroplasty a pain management method that preserves motor strength is increasingly accepted as part of the perioperative rehabilitation protocol Although peripheral nerve blocks like the femoral nerve block FNB can cause significant loss of quadriceps muscle strength and delayed rehabilitation due to the risk of patient falls growing evidence supports the use of the Total knee arthroplasty TKA is a frequently performed major orthopedic surgery where most patients experience severe postoperative pain Pain-related delays in patient mobilization can lead to thromboembolism deep vein thrombosis surgical site infection and increased risk of hospital-acquired infections due to prolonged hospital stay Optimal postoperative knee analgesia is crucial not only for patient comfort and satisfaction but also for accelerating mobilization functional recovery and discharge from the hospital To facilitate early ambulation and superior performance multimodal analgesia and motor-sparing blocks are increasingly utilized
Regional anesthesia techniques are among the most effective methods for postoperative analgesia Peripheral nerve blocks a type of regional anesthesia provide ideal postoperative analgesia due to their ability to offer effective analgesia reduce opioid requirements and associated side effects and facilitate recovery by effectively managing dynamic pain
The innervation of the knee joint is supplied by branches from the femoral nerve obturator nerve common peroneal nerve and tibial nerve which originate from the lumbar and sacral plexuses responsible for lower extremity innervation
adductor canal block ACB in total knee arthroplasty patients for minimal motor involvement or purely sensory block
The adductor canal block ACB is a predominantly sensory nerve block that includes the saphenous nerve the nerve to the vastus medialis muscle and the articular branches of the obturator nerve When performed successfully it provides analgesia similar to the femoral nerve block without significant motor loss in the thigh It is primarily used for lower extremity surgeries such as total knee arthroplasty anterior cruciate ligament reconstruction and meniscus repair
There is increasing interest in the technique called iPACK infiltration between the popliteal artery and capsule of the knee which involves injecting local anesthetics into the space between the popliteal artery and the posterior capsule of the knee This approach blocks the terminal branches of the genicular nerves and the popliteal plexus which innervate the posterior capsule of the knee while sparing the main trunks of the tibial and common peroneal nerves Therefore the iPACK block appears advantageous by providing motor-sparing posterior knee analgesia with a lower likelihood of nerve or vascular injury under ultrasound guidance Studies have shown that combining ACB with the iPACK block provides significantly better postoperative numerical rating scale NRS scores knee range of motion and ambulation distances compared to ACB alone
Regional anesthesia techniques are among the most effective methods for postoperative analgesia Peripheral nerve blocks a type of regional anesthesia provide ideal postoperative analgesia due to their ability to offer effective analgesia reduce opioid requirements and associated side effects and facilitate recovery by effectively managing dynamic pain
The innervation of the knee joint is supplied by branches from the femoral nerve obturator nerve common peroneal nerve and tibial nerve which originate from the lumbar and sacral plexuses responsible for lower extremity innervation
adductor canal block ACB in total knee arthroplasty patients for minimal motor involvement or purely sensory block
The adductor canal block ACB is a predominantly sensory nerve block that includes the saphenous nerve the nerve to the vastus medialis muscle and the articular branches of the obturator nerve When performed successfully it provides analgesia similar to the femoral nerve block without significant motor loss in the thigh It is primarily used for lower extremity surgeries such as total knee arthroplasty anterior cruciate ligament reconstruction and meniscus repair
There is increasing interest in the technique called iPACK infiltration between the popliteal artery and capsule of the knee which involves injecting local anesthetics into the space between the popliteal artery and the posterior capsule of the knee This approach blocks the terminal branches of the genicular nerves and the popliteal plexus which innervate the posterior capsule of the knee while sparing the main trunks of the tibial and common peroneal nerves Therefore the iPACK block appears advantageous by providing motor-sparing posterior knee analgesia with a lower likelihood of nerve or vascular injury under ultrasound guidance Studies have shown that combining ACB with the iPACK block provides significantly better postoperative numerical rating scale NRS scores knee range of motion and ambulation distances compared to ACB alone
Study Oversight
Has Oversight DMC:
None
Is a FDA Regulated Drug?:
None
Is a FDA Regulated Device?:
None
Is an Unapproved Device?:
None
Is a PPSD?:
None
Is a US Export?:
None
Is an FDA AA801 Violation?:
None