Comparison of Adductor Canal Block and IPACK Block With Adductor Canal Block Alone After Total Knee Arthroplasty
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 发起方
- 入组人数
- 88
- 试验地点
- 2
- 主要终点
- Morphine consumption
研究概览
简要总结
Adductor canal block (ACB) is a peripheral nerve blockade technique that provides good pain control in patients undergoing total knee arthroplasty (TKA) which however does not relieve posterior knee pain. The recent technique of an ultrasound-guided local anesthetic infiltration of the interspace between popliteal artery and the capsule of posterior knee (IPACK) has shown promising results in providing significant posterior knee analgesia without affecting the motor nerves. The hypothesis was that the combination of ACB + IPACK will provide better pain relief and improve knee function in the immediate postoperative period compared to ACB alone.
详细描述
This is a prospective, randomized and double blinded study
All patients received :
- Pregabalin 150 mg preoperatively 12 h before the surgery.
- Single-shot spinal anesthesia with 10 to 12 mg of bupivacaine 0.5% and 2.5ug sufentanil patients were randomly allocated to receive:
- Group 1: IPACK + ACB single shoot
- Group 2: contineous ACB For group 1: IPACK was realized after spinal anesthesia with 40 ml ropivacaine 0.2% All patients received ACB in the immediate postoperative period with 20 ml ropivacaine 0.2%
Post operative analgesia included:
- Paracetamol 1g IV every 6 hours
- Diclofenac sodium (50mg) 1 tablet x 2 per day
- Pregabalin 150 mg given orally once daily for a period of 4 weeks.
- PCA morphine (Patient Controlled Analgesia), as a rescue analgesia,
- Continuous ACB catheter for 48H with :
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
- Double (Participant, Outcomes Assessor)
入排标准
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •primary total knee arthroplasty under spinal anesthesia
排除标准
- •Contraindication or refusal to regional anesthesia
- •Contraindication to non steroidal anti inflammatory (NSAID's)
- •Allergy to opioids
- •Allergy to paracetamol
- •Creatinine clearance < 30ml/min
- •Weight<50 kg or >100kg
结局指标
主要结局
Morphine consumption
时间窗: Day 2
total Morphine consumption
次要结局
- functional status(Month 6)
- Pain score during mouvment(Day 2 [0=no pain ; 10=worste pain])
- Chronic pain(Month 6)
- Pain score at rest(Day 2)
- Ambulation distance(Day 2)
研究者
Olfa kaabachi, MD
Professor
University Tunis El Manar