Comparison of Distal IPACK and Popliteal Plexus Block Combined With Femoral Triangle Block After Total Knee Arthroplasty
试验速览
- 阶段
- 不适用
- 状态
- 招募中
- 发起方
- 入组人数
- 120
- 试验地点
- 1
- 主要终点
- Opioid consumption
研究概览
简要总结
This study aims to investigate the effect of femoral triangle block combined with popliteal plexus block and distal IPACK block on postoperative pain after total knee arthroplasty (TKA)
详细描述
Popliteal Plexus Block (PPB) is a new nerve block technique that has been shown to anaesthetise nerves involved in the innervation of the posterior part of the knee joint.
The IPACK (interspace between the popliteal artery and capsule of the posterior knee) block is a regional anesthesia technique in which a local anesthetic is infiltrated under ultrasound guidance between the popliteal artery and the capsule of the posterior knee. This technique blocks the branches of the obturator nerve, the common peroneal nerve, and the tibial nerve in the popliteal region. In the context of knee arthroplasty, the application of the IPACK block has been associated with lower scores for ambulatory pain, lower scores for resting pain, and reduced morphine consumption.
Although both techniques of blockade seem to be efficient in the context of analgesia for the posterior part of the knee after TKA. No study compares these two blocks as part of multimodal analgesia to provide pain relief after TKA.
This study aimed to evaluate the analgesic effect of PPB or distal IPACK, in addition to femoral triangle block, as a component of a multimodal analgesic regimen after TKA.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Treatment
- 盲法
- Quadruple (Participant, Care Provider, Investigator, Outcomes Assessor)
入排标准
- 年龄范围
- 18 Years 至 85 Years（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Patients undergoing total knee arthroplasty under spinal anesthesia
- •American Society of Anesthesiologists (ASA) status I-III
- •Patients who give informed consent
排除标准
- •Patients unable to cooperate
- •Kidney disease with GFR < 50 ml/min
- •Daily opioid consumption > 1 month
- •Allergy to local anesthetics
- •Neurological problems of the lower extremity
- •Contraindications to peripheral nerve blocks
研究组 & 干预措施
Group Popliteal plexus block
femoral triangle block and popliteal plexus block
干预措施: femoral triangle block and popliteal plexus block (Device)
Group distal iPACK
Femoral triangle block and distal iPACK
干预措施: Femoral triangle block and distal iPACK (Device)
结局指标
主要结局
Opioid consumption
时间窗: 24 hours
Total opioid consumption in each group, A, B until 24 hours postoperative.
次要结局
- Post-block MVIC by ankle plantarflexion, calculated as a percentage of the Pre-block baseline value(A 60-minute interval is between pre-block and post-block MVIC assessments)
- Post-block MVIC by ankle dorsiflexion, calculated as a percentage of the Pre-block baseline value(A 60 minutes interval is between pre-block and post-block MVIC assessments)
- Muscle strength of knee extension, graded by Manual Muscle Test (MMT)(Assessed pre-block, post-block (60 minutes after pre-block), and postoperative 5 hours)
- NRS scores(48 hours)
- Range of knee motion(48 hours)
- Post-block Maximum Voluntary Isometric Contraction (MVIC) by knee extension, calculated as a percentage of the Pre-block baseline value(A 60-minute interval is between pre-block and post-block MVIC assessments)
- Incidence of rebound pain(Postoperative 24 hours)
- Quality of Recovery 15 Score(Postoperative Day 1)
- Patient mobilization(48 hours)
- Muscle strength of ankle plantarflexion, graded by MMT(Assessed pre-block, post-block (60 minutes after pre-block) and postoperative 5 hours)
- Muscle strength of ankle dorsiflexion, graded by MMT(Assessed pre-block, post-block (60 minutes after pre-block) and postoperative 5 hours)