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Abstract
Background and Aims Pain and motor blockage are problems that can prevent early discharge from knee arthroscopy. On the one hand, the use of neuraxial techniques or peripheral nerve blockages that produce motor blockage prevents early wandering. On the other hand, the lack of use of regional anesthesia techniques can cause pain that prevents early discharge (1). The saphenous nerve block has been extensively described for this type of intervention because it exclusively generates sensory blockage (2–3). The use of IPACK block is practically not described in knee arthroscopy. However, in knee arthroplasty it is widely used since it generates sensory blockage improving analgesic efficacy and avoiding prolonged motor blockade of the sciatic nerve. (4)
Methods Case report. This is a 48-year-old man who undergoes knee arthroscopy for meniscopathy. The saphenous nerve block is performed with 37.5 mg of Levobupivacaine in 5 ml, and IPACK block with 100 mg of Levobupivacaine in 20 ml. Subsequently, general anesthesia is performed with a laryngeal mask and balanced anesthesia without further analgesic demands.
Results At the time of discharge, the patient encounters VAS 1–2/10, and a Bromage scale of IV/IV. The patient initiates early ambulation and is discharged without subsequent readmission.
Conclusions The combination of two purely sensitive blockages (saphenous and IPACK block) allows adequate analgesic control without motor blockade, ideal for ambulatory surgery. This could be the basis of future protocols for ambulatory knee arthroscopy.