Fascia Iliaca Compartment Block and iPACK Block in Total Knee Arthroplasty

Ankara Ataturk Sanatorium Training and Research Hospital

Status: Active, not recruiting

Conditions: Analgesia; Arthropathy of Knee

Treatments: Procedure: no peripheral block; Procedure: Fascia Iliaca Compartment Block; Procedure: iPACK Block

Study type: Observational

Funder types: Other

Identifiers

NCT06125067

2012-KAEK-15/2719

Details and patient eligibility

About

The investigators sought to compare the effectiveness of postoperative pain control between the standard intravenous multimodal analgesia procedure used in managing patients undergoing total knee surgery, who experience severe postoperative analgesia needs, and multimodal analgesia procedures that incorporate ultrasound-guided peripheral nerve blocks (Fascia Iliaca Compartment Block or iPACK Block) during postoperative follow-up. The aim is to determine which procedure is more effective.

Full description

All patients who received a total knee replacement surgery conducted by orthopaedic surgeons at the operating theatre of Health Sciences University Ankara Atatürk Sanatorium Training and Research Hospital and underwent postoperative pain assessment by anaesthetists will be retrospectively reviewed as part of the study.

Postoperative pain management follow-up for patients who have undergone surgical procedures at Anaesthesiology and Reanimation Clinic is standard practice during patients hospitalization. Patients who have undergone painful and significant surgical procedures are typically given postoperative patient-controlled analgesia devices and are administered intravenous painkillers that are under the patient's control. As part of multimodal analgesia procedure, the investigators apply peripheral nerve blocks routinely to eligible patients, provided that the necessary criteria are met. Once the postoperative Anesthesiology and Reanimation clinic's follow-up form, the regional anaesthesia follow-up form, is completed, patients receive coordinated follow-up care from anaesthesiologists and surgical physicians in postoperative ward to monitor analgesic requirements and increase patient satisfaction. Hourly monitoring ensures that patients receive optimal care.

The aims of study to examine the effectiveness of these procedures. The investigators will include all patients who received elective total knee arthroplasty surgery in the operating room of Ankara Atatürk Sanatorium Training and Research Hospital within the past year (between 01 March 2022 and 31 March 2023) in retrospective file review and postoperative pain follow-up study.

Enrollment: 120 patients

Sex: All

Ages: 18 to 89 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Patients who have undergone elective total knee surgery
• ASA I-III patients

Exclusion criteria

• Those <30 kg
• People under 18 years of age
• Patients with missing follow-up forms
• Patients with a history of chronic opioid or corticosteroid use
• Patients with a history of inflammatory gonathrosis
• Patients with synovectomy operation history

Trial design

120 participants in 3 patient groups

Control Group (no peripheral block applied)

Description:

No peripheral block was applied to this group and it was accepted as the control group. Standard multimodal analgesia and rescue analgesia according to NRS score were applied to each group

Treatment:

Procedure: no peripheral block

Fascia Iliaca Compartment Block Group

Description:

Fascia Iliaca Compartment block was applied to this group under ultrasound guidance. Standard multimodal analgesia and rescue analgesia according to NRS score were applied to each group.

Treatment:

Procedure: Fascia Iliaca Compartment Block

iPACK Block Group

Description:

iPACK block was applied to this group under ultrasound guidance. Standard multimodal analgesia and rescue analgesia according to NRS score were applied to each group.

Treatment:

Procedure: iPACK Block