Ultrasound-Guided 4-in-1 Block Versus Combined Genicular Nerve and iPACK Blocks for Postoperative Analgesia in Total Knee Arthroplasty: A Randomised Clinical Trial
试验速览
- 阶段
- 3 期
- 状态
- 尚未招募
- 发起方
- 入组人数
- 120
- 试验地点
- 1
- 主要终点
- To compare the Analgesic efficacy of ultrasound-guided 4-in-1 Block versus ultrasound-guided genicular nerve block with iPACK block postoperatively for patients undergoing total knee arthroplasty, measured by the Visual Analogue Scale.
研究概览
简要总结
Effective postoperative analgesia for total knee arthroplasty(TKA) requires addressing the complex innervation of knee joint. The femoral nerve innervates the anterior and medial aspects of the knee, and branches of the sciatic nerve innervate the posterior aspects of the knee capsule. The 4 in 1 block is a novel technique designed to anaesthetise the saphenous nerve, obturator nerve, nerve to vastus medialis, and sciatic nerve using a single injection, potentially offering complete analgesia for TKA. Infiltration between the popliteal artery and capsule of the knee(iPACK) block provides analgesia to the posterior compartment of the knee without causing any motor weakness, and the genicular nerve block targets the articular branches innervating the anterior, medial and superolateral aspects of the knee and has motor sparing effect. In this study, we hypothesise that 4 in 1 block would provide better postoperative analgesia after TKA compared to genicular nerve block with iPACK block..
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 盲法
- Participant and Investigator Blinded
入排标准
- 年龄范围
- 18.00 Year(s) 至 80.00 Year(s)（—）
- 性别
- All
入选标准
- •ASA 1,2 and 3 BMI less than 30.
排除标准
- •Exclusion criteria: Patients unwilling to enrol for the study Change in the plan of anaesthesia Patients with a history of allergy to the drugs used in the study Patients with infection at the site of injection.
- •Chronic opioid use Neuropathy Bilateral TKR Surgeries extending beyond 3 hours duration.
结局指标
主要结局
To compare the Analgesic efficacy of ultrasound-guided 4-in-1 Block versus ultrasound-guided genicular nerve block with iPACK block postoperatively for patients undergoing total knee arthroplasty, measured by the Visual Analogue Scale.
时间窗: Postoperatively at 2,4,6,12 and 24 hours
次要结局
- To assess the requirement of postoperative rescue analgesia(End of surgery till 24 hours postoperatively)
- To assess the ease of the procedure in terms of duration(From insertion of the needle till the needle is taken out after final injection)
- To evaluate the time to mobilisation postoperatively(From end of surgery to the time when the patient walks first)
- To assess the incidence of complications like hematoma and nerve injury(End of surgery till 24 hours postoperatively)
研究者
Pradeesh Johny T
Aarupadai Veedu Medical College,Puducherry