Erector Spinae Plane Block vs. iPACK Block With Adductor Canal Block for Total Knee Arthroplasty

Phase 4

Recruiting

• Conditions: Knee Pain Chronic; Knee Osteoarthritis; Knee Arthritis
• Interventions: Drug: Ropivacaine 0.2% Injectable Solution iPACK+ACB; Drug: Control Test - spinal anesthesia; Drug: Ropivacaine 0.2% Injectable Solution ESPB

• Registration Number: NCT06233630
• Lead Sponsor: Poznan University of Medical Sciences

Brief Summary

Effect of Erector Spinae Plane Block and iPACK block with Adductor Canal Block on pain management, and NLR and PLR following knee arthroplasty

Detailed Description

Knee arthroplasty is one of the most common orthopedic procedures, especially in elderly patients, due to the deformation of joints. Patients may complain of severe pain due to surgical trauma and prosthesis. Regional anesthesia methods may be performed to reduce the inflammatory 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 emphasized. However, very few studies have evaluated the effect of various methods of anesthesia on the NLR.

Study Timeline

• Status Verified: 2024-01
• Study First Submitted: 2024-01-22
• Study First Submitted QC: 2024-01-22
• Study First Posted: 2024-01-31
• Study Start: 2024-03-30
• Last Update Submitted: 2024-06-17
• Last Update Posted: 2024-06-20
• Primary Completion: 2025-03-30
• Study Completion: 2025-05-30

Recruitment & Eligibility

• Status: RECRUITING
• Sex: All
• Target Recruitment: 30

Inclusion Criteria

• Patients with ASA classification I-III,
• Aged 20-100 years,
• 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
• do not accept the procedure

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Arm && Interventions

Group	Intervention	Description
Infiltration Popliteal Artery and Capsule of the Knee and Adductor Canal Block	Ropivacaine 0.2% Injectable Solution iPACK+ACB	spinal anaesthesia and ultrasound guided Infiltration of local anesthetic between the Popliteal Artery and Capsule of the Knee (iPACK) block - 20ml 0.2% ropivacaine + ultrasound guided Adductor Canal Block - 10ml 0.2% ropivacaine
Placebo	Control Test - spinal anesthesia	Only spinal anaesthesia - No peripheral nerve block
Erector Spinae Plane Block	Ropivacaine 0.2% Injectable Solution ESPB	spinal anaesthesia and unilateral ultrasound guided erector spinae plane block - 20ml 0.2% ropivacaine

Primary Outcome Measures

Name	Time	Method
Opioid consumption	48 hours	Total opiate consumption after surgery

Secondary Outcome Measures

Name	Time	Method
Numerical Rating Scale [range 0:10]	24 hours after surgery	Postoperative pain assessment will be performed using the NRS score (0 = no pain, 10 = the most severe pain felt)
first need of opiate	48 hours	Time after surgery when the patient needs opiate for the first time
NLR	24 hours postoperatively	Neutrophil-to-lymphocyte ratio
PLR	24 hours postoperatively	Platelet-to-lymphocyte ratio
Quadriceps muscle strength assessed using medical research council scale [range 0:5]	24 hours after surgery	Quadriceps muscle strength (knee extension and hip adduction) will be evaluated according to the medical research council muscle strength rating

Trial Locations

Locations (1)

Poznan University of Medical Sciences; 🇵🇱 Poznań, Poland