Background and Aims Adductor canal block (ACB) is a peripheral nerve block that provides good pain control and faster recovery in patients undergoing total knee arthroplasty (TKA). Ultrasound-guided local anesthetic infiltration of the interspace between the popliteal artery and theposterior knee capsule (IPACK) has shown promising results in reducing postoperative pain without affecting the motor nerves. The aim of this study is to compare the postoperative analgesic and functional effects between the combination of ACB +IPACK and continuous ACB alone after TKA.
Methods This was a prospective, randomized, and double blinded study including patients undergoing unilateral primary TKA under spinal anesthesia anddivided into 2 groups: Group 1: IPACK + ACB (n=42) and Group 2: ACB (n=41). All patients received a standardized anesthetic and analgesic protocol.The main endpoint was total morphine consumption at 48 h, and secondary endpoints were the Numeric Rating Scale(NRS) and the ambulation test.
Results We enrolled 83 patients. General characteristics and preoperative data were comparable in both groups. There were no differences in pain intensity using NRS at rest or during movement (90 flexions of the knee) (figure 1 and figure 2). Also, there were no differences in the duration of the ambulation test or the distance ambulated between groups on POD1 and 2. However the NRS score during ambulation test was higher in group 1( p=0,032) (table 1 ).
Conclusions Our results suggest that the combination of ACB with IPACK block may be an alternative to continuous ACB regarding faster recovery.
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