Pain Management After Adductor Canal Block for Total Knee Arthroplasty

Phase 4

Completed

• Conditions: Knee Pain Chronic; Knee Osteoarthritis; Knee Arthritis; Knee Arthropathy
• Interventions: Drug: 0.9%sodium chloride; Drug: Ropivacaine 0.2% Injectable Solution

• Registration Number: NCT06086483
• Lead Sponsor: Poznan University of Medical Sciences

Brief Summary

This randomized, double-blinded, placebo-controlled trial sought to evaluate the efficacy of the iPACK block with Adductor Canal Block on postoperative pain, functional recovery and NLR and PLR levels.

Detailed Description

The Interspace between the popliteal artery and capsule of the posterior knee, or iPACK block, together with the Adductor Canal block (ACB), has been described and shows promise in providing analgesia to the knee joint. However, the effect of these two blocks on postoperative pain levels, functional recovery, and stress response is uncertain. This study compares a preoperative iPACK and ACB block to Sham blocks before total knee arthroplasty under spinal anesthesia.

Study Timeline

• Study Start: 2020-06-18
• Primary Completion: 2022-07-20
• Study Completion: 2023-08-24
• Status Verified: 2023-10
• Study First Submitted: 2023-10-11
• Study First Submitted QC: 2023-10-11
• Last Update Submitted: 2023-10-11
• Study First Posted: 2023-10-17
• Last Update Posted: 2023-10-17

Recruitment & Eligibility

• Status: COMPLETED
• Sex: All
• Target Recruitment: 361

Inclusion Criteria

• Patients > 18 years old undergoing unilateral total knee arthroplasty

Exclusion Criteria

• refusal to participate
• < 18 yo
• Chronic opioid use
• localized infection

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Arm && Interventions

Group	Intervention	Description
Sham blocks	0.9%sodium chloride	Patients received a preoperative ultrasound-guided iPACK block with 20 mL of 0.9% normal saline and an Adductor Canal block with 20mL 0.9% normal saline.
iPACK block+ABC block	Ropivacaine 0.2% Injectable Solution	Patients received a preoperative ultrasound-guided iPACK block with 20 mL of 0.25% ropivacaine and an Adductor Canal block with 20mL 0.25% ropivacaine.

Primary Outcome Measures

Name	Time	Method
postoperative Numeric Pain Rating Scale	24 hours after surgery	Numeric Pain Rating Scale. The 11-point numeric scale ranges from '0' representing one pain extreme (e.g. "no pain") to '10' representing the other pain extreme (e.g. "pain as bad as you can imagine" or "worst pain imaginable")
postoperative Numeric Pain Rating Scale during active flexion	96 hours after surgery	Numeric Pain Rating Scale. The 11-point numeric scale ranges from '0' representing one pain extreme (e.g. "no pain") to '10' representing the other pain extreme (e.g. "pain as bad as you can imagine" or "worst pain imaginable")
postoperative Numeric Pain Rating Scale et rest	96 hours after surgery	Numeric Pain Rating Scale. The 11-point numeric scale ranges from '0' representing one pain extreme (e.g. "no pain") to '10' representing the other pain extreme (e.g. "pain as bad as you can imagine" or "worst pain imaginable")

Secondary Outcome Measures

Name	Time	Method
Platelet-to-lymphocyte ratio	24 hours after surgery	Platelet-to-lymphocyte ratio
Postoperative opioid consumption	96 hours after surgery	milligrams of intravenous morphine equivalents
Neutrophil-to-lymphocyte ratio	24 hours after surgery	Neutrophil-to-lymphocyte ratio
Time to first opioid administration	96 hours postoperatively	Hours to first administration of an intravenous opioid drug

Trial Locations

Locations (1)

Poznan University of Medical Sciences; 🇵🇱 Poznan, Poznań, Poland