Fascia Iliaca Compartment Block and IPACK Block in Total Knee Arthroplasty

Completed

• Conditions: Arthropathy of Knee; Analgesia
• Interventions: Procedure: iPACK Block; Procedure: no peripheral block; Procedure: Fascia Iliaca Compartment Block

• Registration Number: NCT06125067
• Lead Sponsor: Ankara Ataturk Sanatorium Training and Research Hospital

Brief Summary

The investigators sought to compare the effectiveness of postoperative pain control between the standard intravenous multimodal analgesia procedure used in managing patients undergoing total knee surgery, who experience severe postoperative analgesia needs, and multimodal analgesia procedures that incorporate ultrasound-guided peripheral nerve blocks (Fascia Iliaca Compartment Block or iPACK Block) during postoperative follow-up. The aim is to determine which procedure is more effective.

Detailed Description

All patients who received a total knee replacement surgery conducted by orthopaedic surgeons at the operating theatre of Health Sciences University Ankara Atatürk Sanatorium Training and Research Hospital and underwent postoperative pain assessment by anaesthetists will be retrospectively reviewed as part of the study.

Postoperative pain management follow-up for patients who have undergone surgical procedures at Anaesthesiology and Reanimation Clinic is standard practice during patients hospitalization. Patients who have undergone painful and significant surgical procedures are typically given postoperative patient-controlled analgesia devices and are administered intravenous painkillers that are under the patient's control. As part of multimodal analgesia procedure, the investigators apply peripheral nerve blocks routinely to eligible patients, provided that the necessary criteria are met. Once the postoperative Anesthesiology and Reanimation clinic's follow-up form, the regional anaesthesia follow-up form, is completed, patients receive coordinated follow-up care from anaesthesiologists and surgical physicians in postoperative ward to monitor analgesic requirements and increase patient satisfaction. Hourly monitoring ensures that patients receive optimal care.

The aims of study to examine the effectiveness of these procedures. The investigators will include all patients who received elective total knee arthroplasty surgery in the operating room of Ankara Atatürk Sanatorium Training and Research Hospital within the past year (between 01 March 2022 and 31 March 2023) in retrospective file review and postoperative pain follow-up study.

Study Timeline

• Study First Submitted: 2023-11-04
• Study First Submitted QC: 2023-11-04
• Study First Posted: 2023-11-09
• Study Start: 2024-04-01
• Primary Completion: 2024-07-31
• Status Verified: 2024-12
• Study Completion: 2024-12-01
• Last Update Submitted: 2024-12-09
• Last Update Posted: 2024-12-12

Recruitment & Eligibility

• Status: COMPLETED
• Sex: All
• Target Recruitment: 120

Inclusion Criteria

• Patients who have undergone elective total knee surgery
• ASA I-III patients

Exclusion Criteria

• Those <30 kg
• People under 18 years of age
• Patients with missing follow-up forms
• Patients with a history of chronic opioid or corticosteroid use
• Patients with a history of inflammatory gonathrosis
• Patients with synovectomy operation history

Study & Design

• Study Type: OBSERVATIONAL
• Study Design: Not specified

Arm && Interventions

Group	Intervention	Description
iPACK Block Group	iPACK Block	iPACK block was applied to this group under ultrasound guidance. Standard multimodal analgesia and rescue analgesia according to NRS score were applied to each group.
Control Group (no peripheral block applied)	no peripheral block	No peripheral block was applied to this group and it was accepted as the control group. Standard multimodal analgesia and rescue analgesia according to NRS score were applied to each group
Fascia Iliaca Compartment Block Group	Fascia Iliaca Compartment Block	Fascia Iliaca Compartment block was applied to this group under ultrasound guidance. Standard multimodal analgesia and rescue analgesia according to NRS score were applied to each group.

Primary Outcome Measures

Name	Time	Method
Numerical Rating Scale (NRS)	postoperative 24 hours score change	NRS was used to assess postoperative pain. The NRS is a segmented numerical version of the visual analog scale (VAS), in which the respondent chooses an integer (0-10 integer) that best reflects the intensity of his pain. It is considered a one-dimensional measure of pain intensity in adults. It is an 11-point numerical scale. It ranges from "0" representing no pain to "10" representing extreme pain.

Secondary Outcome Measures

Name	Time	Method
5-point likert satisfaction scale	postoperative 24th hour	The patient's satisfaction with postoperative pain treatment will be recorded. 5 options; very dissatisfied, dissatisfied, neither dissatisfied or satisfied, satisfied, very satisfied

Trial Locations

Locations (1)

Ankara Atatürk Sanatorium Training and Research Hospital; 🇹🇷 Ankara, Keçiören, Turkey