Comparison of the Analgesic Effect of Subsartorial Saphenous Block and Popliteal Sciatic vs Subsartorial Saphenous Block and IPACK in Total Knee Replacement Surgery.

Germans Trias i Pujol Hospital

Status: Enrolling

Conditions: Pain, Acute; Knee Osteoarthritis; Anesthesia

Treatments: Drug: IPACK block with Bupivacaine 0.25% with adrenaline

Study type: Interventional

Funder types: Other

Identifiers

NCT06514365

IPACK-20

Details and patient eligibility

About

Total knee replacement surgery is associated with significant pain in the immediate postoperative period, especially in movement. In turn, this is associated with more subsequent chronic pain.

There are multiple options and the tendency is to perform increasingly distal nerve blocks to minimize limb weakness and thus allow early rehabilitation. In 2012, in an oral communication, Sanjay Sinha described a new nerve block called iPACK ("Interspace between the Popliteal Artery and the Capsule of the posterior Knee"). There are few studies on the efficacy of such a blockade so far, but none comparing the groups saphene + sciatic blocks vs. saphene + iPACK blocks.

Therefore, this study aims to provide more information on the effectiveness this nerve blocks, in total knee replacement, in terms of analgesia and motor function.

Enrollment: 62 estimated patients

Sex: Female

Ages: 18+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Patients with osteoarthritis scheduled for total primary knee arthroplasty with same surgeons
• Locoregional anesthesia
• Age equal to or greater than 18 years
• Consent to participate in the study

Exclusion criteria

• Age under 18 years old
• General anesthesia
• Allergy to local anesthetics
• Severe kidney failure (Cr ≥ 2mg / dL)
• Chronic opioid use (over 3 months)
• Chronic pregabalin / gabapentin use (more than 3 months)
• Psychiatric illness that may interfere with the evaluation or follow-up

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Double Blind

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62 participants in 2 patient groups

Echo-guided IPACK block

Experimental group

Description:

IPACK block using 0.25% bupivacaine 15mL with adrenaline once.

Treatment:

Drug: IPACK block with Bupivacaine 0.25% with adrenaline

Echo-guided sciatic block

Active Comparator group

Description:

Sciatic nerve block using 0.25% bupivacaine 15mL with adrenaline once.

Treatment:

Drug: IPACK block with Bupivacaine 0.25% with adrenaline