Comparison of Pain Relief Post Knee Arthroscopy Using IPACK + Adductor Canal Block vs. Adductor Canal Block Alone

Postoperative Pain Clinical Trial

Official title:

Comparison of IPACK Block With Adductor Canal Block vs Adductor Canal Block Alone for Post Operative Analgesia Following Arthroscopic Knee Surgeries

Clinical Trial Details — Status: Recruiting

Administrative data

• NCT number: NCT06265441
• Other study ID #: MS42/2024
• Status: Recruiting
• Phase: N/A
• Start date: May 1, 2024
• Est. completion date: October 1, 2024

Study information

• Verified date: February 2024
• Source: Ain Shams University
• Contact: Mohamed Morsi, M.B.B.CH
• Phone: +201116618163
• Email: MohamedMorsi[@]med.asu.edu.eg
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial Summary

In this study, the invistigators aim to compare postoperative analgesia effectiveness between combined interspace between the popliteal artery and posterior capsule of the knee block (IPACK) and Adductor canal block vs. Adductor canal block alone after Arthroscopic knee surgeries focusing on VAS score assessment at 8 hours postoperative.

Description:

Patients who fulfilled the inclusion criteria and agreed to participate in the study will be randomly divided into two groups using their computer-generated random numbers such that even numbers will be enrolled in group A for Adductor canal block alone and odd numbers will be enrolled in group B for Adductor canal block and IPACK block.

Recruitment information / eligibility

• Status: Recruiting
• Enrollment: 40
• Est. completion date: October 1, 2024
• Est. primary completion date: September 1, 2024
• Accepts healthy volunteers: No
• Gender: All
• Age group: 20 Years to 40 Years

Eligibility

Inclusion Criteria:

• Physical status: ASA 1 or 2 and candidates for spinal anesthesia undergoing Arthroscopic knee surgery.

• Age group: 20-40 years.

• No sex predilection.

Exclusion Criteria:

• Patient refusal

• Physical status: ASA III or above.

• Patients with contraindications for spinal anaesthesia.

• Patients with history of drug allergies to study drugs.

• Evidence of local infection at site of injection.

• Neuromuscular pathology (example: - Multiple Sclerosis)

Related Conditions & MeSH terms

• Pain, Postoperative
• Postoperative Pain

Intervention

Procedure:
• Group A will receive adductor canal block after spinal anesthesia under a high-frequency ultrasound guidance in which the adductor canal is identified and 20 ml of 0.25% bupivacaine will be injected
Patients will receive adductor canal block after spinal anesthesia under a high-frequency ultrasound guidance in which the adductor canal is identified beneath the sartorius muscle and 20 ml of 0.25% bupivacaine will be injected in the canal using a 22-gauge 100-mm short-bevelled regional block needle
• Group B will receive adductor canal block under ultrasound guide 20 ml bupivacaine 0.25% and IPACK block under direct visualization of ultrasound of 20 ml bupivacaine 0.25%
Group B will receive Adductor canal block as described then IPACK in which the patient is placed in a supine position and knee is placed in position of 90° flexion. A low-frequency ultrasound probe is positioned in the popliteal crease, and a spinal needle is inserted from the medial aspect of the knee from anteromedial to posterolateral direction in a plane between the popliteal artery and the femur. The tip of the needle is placed 1-2 cm beyond the lateral edge of the artery, and 20 ml of 0.25% bupivacaine is injected after negative aspiration.

Locations

Country	Name	City	State
Egypt	Ain Shams University	Cairo	Abbassia

Sponsors (1)

Lead Sponsor	Collaborator
Ain Shams University

Country where clinical trial is conducted

Egypt, 

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Assessment of pain using the visual analogue scale (VAS) upon first ambulation after 8 hours from the completion of the surgical procedure and skin closure.	Visual analogue scale (VAS) (scale 0-10, where 0 = no pain and 10 = worst imaginable pain). All the patients will have the VAS score explained and taught for self-assessment of pain at the time of enrolment for the study.	8 hours
Secondary	Total analgesics consumption	Total analgesics consumption (in mg.) over 24-hour period post-operative	24 hours
Secondary	The time till first analgesic requirement	The time (in hours) after finishing of ultrasound guided IPACK or Adductor canal blocks till the patient's requirement for first analgesia postoperative in ward. (All patients will receive intravenous morphine (3mg)/pethidine (30mg) on demand with paracetamol IV/8 hours.)	as requested by patient
Secondary	The range of movement (ROM)	The range of movement (ROM) by assessing the degree of knee extension one day after the surgery	3 days
Secondary	The number of steps	ambulation distance assessed by the number of steps walked by the patient three days after the surgery	3 days