ESPB vs iPACK+ACB in Total Knee Arthroplasty

Poznan University of Medical Sciences (PUMS)

Status and phase: Not yet enrolling; Phase 4

Conditions: Knee Arthritis; Knee Rheumatism; Knee Pain Chronic; Knee Disease; Knee Osteoarthritis; Knee Arthropathy

Treatments: Drug: Ropivacaine 0.2% Injectable Solution; Drug: control group

Study type: Interventional

Funder types: Other

Identifiers

NCT06302218

5/2024

Details and patient eligibility

About

Effect of iPACK block with Adductor Canal Block and ESPB on pain management, and NLR and PLR following knee arthroplasty

Full description

Knee arthroplasty is one of the most common orthopaedic procedures, especially in elderly patients, due to the deformation of joints. Patients may complain of severe pain due to surgical trauma and prostheses. Regional anaesthesia methods may be performed to reduce the surgery's induced stress response, opioid consumption, and opioid-related side effects.

In recent years, the influence of regional anesthesiology on reducing the inflammatory response after surgical procedures has been emphasised. However, very few studies have evaluated the effect of various methods of anaesthesia on the NLR and PLR.

This is the first study to investigate the effect of regional anaesthesia on the pain managementonse expres and stress respsed by the NLR and PLR in patients undergoing knee replacement surgery.

Enrollment: 60 estimated patients

Sex: All

Ages: 18 to 100 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Patients with ASA classification I-III, Aged 20-90 years, Who will be scheduled for knee arthroplasty under spinal anaesthesia.

Exclusion criteria

• patients who have a history of bleeding diathesis,
• take anticoagulant therapy,
• have a History of chronic pain before surgery,
• have Multiple trauma, cannot assess their pain (dementia),
• have been operated on under general anaesthesia,
• have an infection in the area and do not accept the procedure

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Triple Blind

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60 participants in 3 patient groups, including a placebo group

iPACK + ACB

Active Comparator group

Description:

spinal anesthesia + ultrasound guided iPACK (20ml 0,2% ropivacaine) with ACB (10ml 0.5% ropivacaine)

Treatment:

Drug: Ropivacaine 0.2% Injectable Solution

Drug: Ropivacaine 0.2% Injectable Solution

Erectro Spinae Plane Block

Active Comparator group

Description:

spinal anesthesia + ultrasound guided ESPBk - 20ml 0,2% ropivacaine

Treatment:

Drug: Ropivacaine 0.2% Injectable Solution

Drug: Ropivacaine 0.2% Injectable Solution

Control group

Placebo Comparator group

Description:

Only spinal anesthesia - No peripheral nerve block

Treatment:

Drug: control group