Effect of Adding Infiltration between The Popliteal Artery and Capsule of The Knee Block (IPACK) to Continuous Adductor Canal Block after Total Knee Arthroplasty

Abdo, Hatem Mohammed Ahmed; Abd Elaziz, Mohamed Saeed; Elhamid, Amr Essam Eldin Abd; Kassem, Amr Ahmed; Haiba, Diaaeldein Mahmoud

doi:TEJA-2023-0130

Effect of Adding Infiltration between The Popliteal Artery and Capsule of The Knee Block (IPACK) to Continuous Adductor Canal Block after Total Knee Arthroplasty

Authors

TEJA-2023-0130

Abstract

Background
Total knee arthroplasty (TKA) is a major surgical procedure that can be extremely upsetting. There are several methods available for postoperative pain management after knee surgery. One commonly used method is multimodal analgesia based on continuous adductor canal block.
Aim of The Work
Comparing the effect of the addition of posterior knee block, known as the infiltration between the popliteal artery and capsule of the knee (IPACK) block, to continuous adductor canal block (CACB) after total knee arthroplasty.
Patients and Methods
A total of 52 patients who underwent total knee arthroplasty were included and randomly divided into two groups receiving ultrasound-guided continuous adductor canal block or a combination of continuous ultrasound guided adductor canal block and the Infiltration between the popliteal artery and capsule of the knee block at the end of the surgery.
Results
Regarding the criteria for pain control, there was a statistically significant difference between the two groups regarding the postoperative visual analog score at 2, 4, 8, and 12 h after following up, which was not reported at 16 or 24 h postoperatively. The total nalbuphine consumption on the first day postoperative also showed a significant difference. A comparison of the basic demographic data, the onset of ambulation, the Timed Up and Go (TUG) test, and the straight leg raising test revealed no significant difference between the two groups.
Conclusion
Our study found that the use of continuous ultrasound guided adductor canal block and the Infiltration between the popliteal artery and capsule of the knee block together resulted in better postoperative pain management and reduced the need for nalbuphine. Despite this, there were no significant differences between the groups in terms of motor power or ambulation abilities. Trial registration number: PACTR202301536928551

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