Effect of Continuous Adductor Canal Block Versus Continuous Adductor Canal Block With Additional Infiltration Between The Popliteal Artery and Capsule of The Knee (IPACK) After Arthroscopic Knee Surgeries

Not Applicable

Recruiting

• Conditions: Continuous Adductor Canal Block; Infiltration Between The Popliteal Artery and Capsule of The Knee; Arthroscopic Knee Surgeries

• Registration Number: NCT06802419
• Lead Sponsor: Ain Shams University

Brief Summary

This study aims to evaluate the effect of Continuous Adductor Canal Block only versus adding posterior knee block, known as the Infiltration between the Popliteal Artery and Capsule of the Knee (IPACK) block with Continuous Adductor Canal Block (CACB) after arthroscopic knee surgeries.

Detailed Description

Enhanced recovery after arthroscopic knee surgery is gaining popularity in orthopedic surgeries. Motor preservation with adequate analgesia has become the optimal postoperative goal, enabling earlier physical therapy, faster recovery, and early hospital discharge. Spinal anesthesia for knee arthroscopy has favorable outcome effects compared with general anesthesia. The positive physiological effects of the provided sympathetic blockade with less blood loss, increased leg blood flow, and better initial pain relief explain this.

An ideal nerve block that targets the sensory nerves and spares the motor function can facilitate early ambulation and rehabilitation, a major goal for patients undergoing arthroscopic knee surgery.

A novel technique for posterior knee block, known as the infiltration between the popliteal artery and capsule of the knee (IPACK) block combined with continuous adductor canal block (CACB) would reduce opioid requirements.

Study Timeline

• Status Verified: 2025-01
• Study First Submitted: 2025-01-21
• Study Start: 2025-01-30
• Study First Submitted QC: 2025-01-30
• Last Update Submitted: 2025-01-30
• Study First Posted: 2025-01-31
• Last Update Posted: 2025-01-31
• Primary Completion: 2025-10-01
• Study Completion: 2025-10-01

Recruitment & Eligibility

• Status: RECRUITING
• Sex: All
• Target Recruitment: 70

Inclusion Criteria

• Age from 21 to 65 years.
• Both sexes.
• American Society of Anesthesiologists (ASA) Physical Status Class I to II.
• Patients with successful spinal anesthesia.
• Patients scheduled for elective arthroscopic knee surgery for anterior cruciate ligament (ACL) and posterior cruciate ligament (PCL) repair.

Exclusion Criteria

• Declining to give written informed consent.
• History of allergy to the medications used in the study.
• Contraindications to regional anesthesia (including coagulopathy and local infection).
• Polytrauma patients having lower limb fractures.
• Patients with pre-existing myopathy or neuropathy on the operating limb.
• Patients with diabetes mellitus.
• Psychiatric disorder.
• Morbid obesity [body mass index (BMI) > 45kg/m2].
• Complicated Surgery.

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Primary Outcome Measures

Name	Time	Method
Degree of pain	24 hours postoperatively	The degree of pain will be assessed using the Visual Analogue Scale (VAS). VAS score is determined by measuring the distance (mm) on the 10-cm line between the "no pain" anchor and the patient's mark, providing a range of scores from 0-100. No pain (0-4 mm), mild pain (5-44 mm), moderate pain (45-74 mm), and severe pain (75-100 mm).

Secondary Outcome Measures

Name	Time	Method
Total Nalbuphine consumption	24 hours postoperatively	Rescue analgesia will be given when VAS score ≥ 30 mm, in the form of IV injection of 10 mg Nalbuphine. Followed by reassessment of pain after 10 minutes, a second dose of Nalbuphine will be given if still VAS score ≥ 30 mm.
Straight leg rise	24 hours postoperatively	Straight leg rise (SLR) will be recorded.
Range of motion	24 hours postoperatively	Range of motion (ROM) will be recorded
Rate of complications	24 hours postoperatively	Rate of complications like falling will be recorded

Trial Locations

Locations (1)

Ain Shams University; 🇪🇬 Cairo, Egypt