![]() We report a case of genicular nerve block combined with iPACK block for postoperative analgesia after total knee arthroplasty. Genicular nerve block (GNB) provides good analgesia anterior to the knee, while infiltration between the popliteal artery and capsule of the knee (iPACK) block provides good analgesia posterior to the knee. In the context of enhanced recovery after surgery, multimodal analgesia with peripheral nerve block as the core has become the main method of postoperative analgesia after TKA, and good analgesia is conducive to the early recovery of patients. The incidence of moderate to severe pain after total knee arthroplasty (TKA) ranges from 30-60%. Keywords: Total Knee Arthroplasty, Genicular Nerves Block, Infiltration Between the Popliteal Artery and Capsule of Knee, Analgesia, Case Report Abstract This is an open-access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium provided the original work is properly cited. Application of Genicular Nerves Block Combined with iPACK Block in Postoperative Analgesia of Total Knee Arthroplasty. Received date: 28 February 2023 Accepted date: 13 March 2023 Published date: 18 March 2023Ĭitation: Zeng Y, Xu Y. All rights reserved.1 Department of Anesthesiology, West China Hospital, Sichuan University, People’s Republic of ChinaĪddress: Department of Anesthesiology, West China Hospital, Sichuan University, 37# Wainan Guoxue Road, Chengdu 610041, People’s Republic of China. Infiltration of the local anesthetic into the space between the popliteal artery and the posterior capsule of the knee (iPACK). However, patients who received ACB + iPACK block may require higher amounts of opioids and have worse immediate functional performance.Īdductor canal block analgesia iPACK (interspace between the popliteal artery and capsule of the posterior knee) block periarticular injection total knee arthroplasty ultrasound-guidance.Ĭopyright © 2020 Elsevier Inc. 04, respectively) in the ACB + iPACK group.ĪCB with iPACK block provides a noninferior analgesia compared with PAI when combined with CACB. 05) and showed greater reduced quadriceps strength at 0 and 45 degrees on postoperative day 0 (P =. However, morphine requirement at 48 postoperative hours was significantly higher (P <. Background: Several studies have suggested that the addition of iPACK block (the popliteal artery and the posterior knee capsule have been given interspace local anesthetic infiltration) might get better analgesia than adductor canal block (ACB) only after total knee arthroplasty (TKA). The mean visual analog scale pain scores were low and no clinically significant differences between groups. The upper limit of 95% confident interval was lower than the prespecified noninferiority limit. ![]() Pain scores, morphine consumption, functional performance, and adverse events were the secondary outcome measures assessed for superiority.Īdjusted mean differences, (ACB + iPACK) - (ACB + PAI), in anterior and posterior knee pain scores on movement at 12 postoperative hours were -0.66 (-1.86, 0.54) and -0.19 (-1.36, 0.99), respectively. Noninferiority was concluded for the primary outcome if the adjusted mean between-group difference in pain on movement at 12 postoperative hours was within 1.3 points on a visual analog pain scale. Seventy-six patients were randomized to receive either ACB + iPACK block and continuous ACB (CACB) (ACB + iPACK group) or PAI and CACB (ACB + PAI group). IPACK block for analgesia after total knee replacement (Arhtroplasty) Start your 7-day free trial on the NYSORA LMS today and see why it is the go-to resou. Comparison of adductor canal block and IPACK block (interspace between the popliteal artery and the capsule of the posterior knee) with adductor canal block alone after total knee arthroplasty: a prospective control trial on pain and knee function in immediate postoperative period. This study aimed to determine if ACB with iPACK block was noninferior to ACB with periarticular injection (PAI) when combined with postoperative multimodal analgesia regimen. Background: Several studies have suggested that the addition of iPACK block (the popliteal artery and the posterior knee capsule have been given interspace local anesthetic infiltration) might get better analgesia than adductor canal block (ACB) only after total knee arthroplasty (TKA). Sankineani SR, Reddy AR, Eachempati KK, Jangale A, Gurava Reddy AV. ![]() The combination of adductor canal block (ACB) and infiltration between the popliteal artery and the posterior capsule of the knee (iPACK) block may provide sufficient motor-sparing anterior and posterior knee analgesia after total knee arthroplasty.
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