Erector Spinae Plane Block vs. iPACK Block With Adductor Canal Block for Pain Management in Patients Undergoing Total Knee Replacement
Overview
- Phase
- Phase 4
- Status
- Not yet recruiting
- Sponsor
- Poznan University of Medical Sciences
- Enrollment
- 60
- Locations
- 1
- Primary Endpoint
- Opioid consumption
Overview
Brief Summary
Effect of iPACK block with Adductor Canal Block and ESPB on pain management, and NLR and PLR following knee arthroplasty
Detailed Description
Knee arthroplasty is one of the most common orthopaedic procedures, especially in elderly patients, due to the deformation of joints. Patients may complain of severe pain due to surgical trauma and prostheses. Regional anaesthesia methods may be performed to reduce the surgery's induced stress response, opioid consumption, and opioid-related side effects.
In recent years, the influence of regional anesthesiology on reducing the inflammatory response after surgical procedures has been emphasised. However, very few studies have evaluated the effect of various methods of anaesthesia on the NLR and PLR.
This is the first study to investigate the effect of regional anaesthesia on the pain managementonse expres and stress respsed by the NLR and PLR in patients undergoing knee replacement surgery.
Study Design
- Study Type
- Interventional
- Allocation
- Randomized
- Intervention Model
- Parallel
- Primary Purpose
- Treatment
- Masking
- Triple (Participant, Care Provider, Outcomes Assessor)
Eligibility Criteria
- Ages
- 18 Years to 100 Years (Adult, Older Adult)
- Sex
- All
- Accepts Healthy Volunteers
- No
Inclusion Criteria
- •Patients with ASA classification I-III, Aged 20-90 years, Who will be scheduled for knee arthroplasty under spinal anaesthesia.
Exclusion Criteria
- •patients who have a history of bleeding diathesis,
- •take anticoagulant therapy,
- •have a History of chronic pain before surgery,
- •have Multiple trauma, cannot assess their pain (dementia),
- •have been operated on under general anaesthesia,
- •have an infection in the area and do not accept the procedure
Arms & Interventions
iPACK + ACB
spinal anesthesia
- ultrasound guided iPACK (20ml 0,2% ropivacaine) with ACB (10ml 0.5% ropivacaine)
Intervention: Ropivacaine 0.2% Injectable Solution (Drug)
Erectro Spinae Plane Block
spinal anesthesia
- ultrasound guided ESPBk - 20ml 0,2% ropivacaine
Intervention: Ropivacaine 0.2% Injectable Solution (Drug)
Control group
Only spinal anesthesia - No peripheral nerve block
Intervention: control group (Drug)
Outcomes
Primary Outcomes
Opioid consumption
Time Frame: 48 hours after surgery
Total opiate consumption after surgery
Secondary Outcomes
- Time to first rescue opiate analgesia(48 hours after procedure)
- Numerical Rating Scale [range 0:10](Time Frame: 48 hours after surgery)
- Neutrophil-to-lymphocyte ratio(48 hours after surgery)
- Platelet-to-lymphocyte ratio(48 hours after surgery)
- Quadriceps muscle strength assessed using medical research council scale [range 0:5](Postoperative 24 hours period)