Adductor Canal Block Combined With IPACK vs Genicular Nerves Block in Knee Arthroscopy

Arthroscopy Clinical Trial

Official title:

Analgesic Effect of Adductor Canal Block Combined With Infiltration of the Interspace Between Popliteal Artery and the Capsule of the Knee (IPACK) Block Versus Genicular Nerves Block in Knee Arthroscopy

Clinical Trial Details — Status: Not yet recruiting

Administrative data

• NCT number: NCT05269095
• Other study ID #: 35236/1/22
• Status: Not yet recruiting
• Phase: N/A
• Start date: March 21, 2022
• Est. completion date: March 21, 2023

Study information

• Verified date: March 2022
• Source: Tanta University
• Contact: n/a
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial Summary

This prospective randomized controlled study is designed to investigate the postoperative analgesic effect of adductor canal block (ACB) combined with infiltration of the interspace between the popliteal artery and the capsule of posterior knee (IPACK) block compared to genicular nerves block in patients undergoing knee arthroscopy.

Description:

Maintaining patient safety, ensuring best patient outcomes, and optimal pain relief post-operatively are of utmost concern for anesthesia providers. Adequate pain relief attenuates stress responses and long-term chronic pain complications while contributing to improved postoperative outcomes.

Knee arthroscopy is a very common procedure and very often is performed as day-case surgery. Ambulatory arthroscopic surgery of the knee is preferred by the majority of properly selected and well-informed patients. It has been reported that a significant number of patients have moderate to severe pain 24 hours after ambulatory surgery in general and knee arthroscopy in particular and pain affects the patient's activity level and satisfaction. Adductor canal block (ACB) is a popular peripheral nerve block that has been shown to decrease the pain significantly and decrease opioid consumption with minimal effect on quadriceps function. It provides analgesia to the peri-articular and intra-articular aspects of the knee joint but doesn't relieve posterior knee pain which is moderate to severe in intensity.

Recruitment information / eligibility

• Status: Not yet recruiting
• Enrollment: 105
• Est. completion date: March 21, 2023
• Est. primary completion date: March 20, 2023
• Accepts healthy volunteers: No
• Gender: All
• Age group: 21 Years to 60 Years

Eligibility

Inclusion Criteria:

• Age 21-60 years

• Both genders

• American Society of Anaesthesiologists physical status classification I - III

• Patients scheduled for elective unilateral knee arthroscopy under spinal anesthesia

Exclusion Criteria:

• Patient refusal

• Preoperative neurological deficits

• Opioid-dependent (opioid intake more than 3 months)

• Chronic pain conditions

• Significant cardiac and respiratory disease

• Pre-existing major organ dysfunction such as hepatic and renal failure

• Coexisting hematological disorder or deranged coagulation parameters

• Psychiatric illnesses

• Allergy to any of the drugs used in the study

Related Conditions & MeSH terms

• Arthroscopy

Intervention

Procedure:
• Spinal anesthesia only
Patients will receive spinal anesthesia with 2-3 ml 0.5% (10-15 mg) hyperbaric bupivacaine plus 25 ug fentanyl at the L3/4 interspaces.

Biological:
• Spinal anesthesia and ultrasound-guided Genicular nerves block
Patients will receive16 ml bupivacaine 0025% will be administered, and4 ml of this solution will be placed at each of the 4 target nerves.
• Ultrasound-guided Adductor Canal block (ACB) technique with infiltration of the interspace between popliteal artery and the capsule of posterior knee block ('PACK)
Adductor Canal block (ACB) technique will be performed using 16 ml bupivacaine 0025% As regarding the Popliteal artery and the capsule of posterior knee block ('PACK), it will be performed Using 16 ml bupivacaine 0.25%

Locations

Country	Name	City	State
n/a

Sponsors (1)

Lead Sponsor	Collaborator
Tanta University

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Postoperative 24-hour rescue analgesic consumption	Total postoperative 24-hour rescue analgesic consumption will be recorded	24 hours postoperative
Secondary	Post-operative pain	Post-operative pain will be assessed by the Numeric Rating Scale (NRS) rest and mobilization.	24 hours Postoperative
Secondary	Time taken till 1st rescue analgesic request	The time till administration of first rescue analgesia will be recorded	24 hours Postoperative