Pain Management After Adductor Canal Block for Total Knee Arthroplasty

Knee Osteoarthritis Clinical Trial

Official title:

Pain Management and Functional Recovery After Adductor Canal Block Combined With iPACK Block for Total Knee Arthroplasty. A Prospective, Randomized, Double-blinded Clinical Trial.

Clinical Trial Details — Status: Completed

Administrative data

• NCT number: NCT06086483
• Other study ID #: 495/2020
• Status: Completed
• Phase: Phase 4
• Start date: June 18, 2020
• Est. completion date: August 24, 2023

Study information

• Verified date: October 2023
• Source: Poznan University of Medical Sciences
• Contact: n/a
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial 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.

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.

Recruitment information / eligibility

• Status: Completed
• Enrollment: 361
• Est. completion date: August 24, 2023
• Est. primary completion date: July 20, 2022
• Accepts healthy volunteers: No
• Gender: All
• Age group: 18 Years to 100 Years

Eligibility

Inclusion Criteria:

• Patients > 18 years old undergoing unilateral total knee arthroplasty

Exclusion Criteria:

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

Related Conditions & MeSH terms

• Joint Diseases
• Knee Arthritis
• Knee Arthropathy
• Knee Osteoarthritis
• Knee Pain Chronic
• Osteoarthritis
• Osteoarthritis, Knee

Intervention

Drug:
• Ropivacaine 0.2% Injectable Solution
20 mL 0.5% ropivacaine was injected into the PENG block 20 mL 0.5% ropivacaine was injected into the Adductor Canal block
• 0.9%sodium chloride
20 mL 0.9% sodium chloride was injected into the PENG block 20 mL 0.5% sodium chloride was injected into the Adductor Canal block

Locations

Country	Name	City	State
Poland	Poznan University of Medical Sciences	Poznan	Poznan

Sponsors (1)

Lead Sponsor	Collaborator
Poznan University of Medical Sciences

Country where clinical trial is conducted

Poland, 

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	postoperative Numeric Pain Rating Scale	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")	24 hours after surgery
Primary	postoperative Numeric Pain Rating Scale et rest	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")	48 hours after surgery
Primary	postoperative Numeric Pain Rating Scale et rest	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")	72 hours after surgery
Primary	postoperative Numeric Pain Rating Scale et rest	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")	96 hours after surgery
Primary	postoperative Numeric Pain Rating Scale during active flexion	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")	48 hours after surgery
Primary	postoperative Numeric Pain Rating Scale during active flexion	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")	72 hours after surgery
Primary	postoperative Numeric Pain Rating Scale during active flexion	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")	96 hours after surgery
Secondary	Postoperative opioid consumption	milligrams of intravenous morphine equivalents	96 hours after surgery
Secondary	Neutrophil-to-lymphocyte ratio	Neutrophil-to-lymphocyte ratio	12 hours after surgery
Secondary	Neutrophil-to-lymphocyte ratio	Neutrophil-to-lymphocyte ratio	24 hours after surgery
Secondary	Platelet-to-lymphocyte ratio	Platelet-to-lymphocyte ratio	12 hours after surgery
Secondary	Platelet-to-lymphocyte ratio	Platelet-to-lymphocyte ratio	24 hours after surgery
Secondary	Time to first opioid administration	Hours to first administration of an intravenous opioid drug	96 hours postoperatively