Comparison of Distal IPACK and Popliteal Plexus Block Combined With Femoral Triangle Block After Total Knee Arthroplasty

Karaman Training and Research Hospital

Status: Enrolling

Conditions: Osteo Arthritis of the Knee

Treatments: Device: Femoral triangle block and distal iPACK; Device: femoral triangle block and popliteal plexus block

Study type: Interventional

Funder types: Other

Identifiers

NCT07130552

06-2022/16

Details and patient eligibility

About

This study aims to investigate the effect of femoral triangle block combined with popliteal plexus block and distal IPACK block on postoperative pain after total knee arthroplasty (TKA)

Full description

Popliteal Plexus Block (PPB) is a new nerve block technique that has been shown to anaesthetise nerves involved in the innervation of the posterior part of the knee joint.

The IPACK (interspace between the popliteal artery and capsule of the posterior knee) block is a regional anesthesia technique in which a local anesthetic is infiltrated under ultrasound guidance between the popliteal artery and the capsule of the posterior knee. This technique blocks the branches of the obturator nerve, the common peroneal nerve, and the tibial nerve in the popliteal region. In the context of knee arthroplasty, the application of the IPACK block has been associated with lower scores for ambulatory pain, lower scores for resting pain, and reduced morphine consumption.

Although both techniques of blockade seem to be efficient in the context of analgesia for the posterior part of the knee after TKA. No study compares these two blocks as part of multimodal analgesia to provide pain relief after TKA.

This study aimed to evaluate the analgesic effect of PPB or distal IPACK, in addition to femoral triangle block, as a component of a multimodal analgesic regimen after TKA.

Enrollment: 120 estimated patients

Sex: All

Ages: 18 to 85 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Patients undergoing total knee arthroplasty under spinal anesthesia
• American Society of Anesthesiologists (ASA) status I-III
• Patients who give informed consent

Exclusion criteria

• Patients unable to cooperate
• Kidney disease with GFR < 50 ml/min
• Daily opioid consumption > 1 month
• Allergy to local anesthetics
• Neurological problems of the lower extremity
• Contraindications to peripheral nerve blocks

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Quadruple Blind

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120 participants in 2 patient groups

Group Popliteal plexus block

Experimental group

Description:

femoral triangle block and popliteal plexus block

Treatment:

Device: femoral triangle block and popliteal plexus block

Group distal iPACK

Experimental group

Description:

Femoral triangle block and distal iPACK

Treatment:

Device: Femoral triangle block and distal iPACK