Efficacy of Ipack Block and Surgeon's Joint Infiltration in Total Knee Arthroplasty

Icahn School of Medicine at Mount Sinai99 enrolled

Overview

Total knee arthroplasty(TKA) is an effective modality for the treatment of advanced osteoarthritis of the knee joint with excellent outcomes. With 719,000 cases being performed as of 2010, the incidence is expected to increase up to 3.48 million procedures annually by 2030.

There have been several studies regarding efficacy of peri articular infiltration. IPACK block is a novel technique gaining popularity where one injects local anesthesia safely under ultrasound guidance in the interspace between the popliteal artery and capsule of the knee. There have been no studies till date comparing the efficacy between IPACK block and Periarticular Infiltration (PAI).

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

QUADRUPLE

Enrollment

Conditions

Osteo Arthritis Knee

Interventions

IpackDEVICE

IPACK block - local anesthesia injected safely under ultrasound guidance in the interspace between the popliteal artery and capsule of the knee.

BupivacaineDRUG

20 cc of bupivacaine(o.25%) injection

Peri Articular InfiltrationPROCEDURE

Adductor Canal Catheter and Peri Articular Infiltration

Eligibility

Sex: ALLMin age: 18 YearsMax age: 75 YearsHealthy volunteers:

Medical Language ↔ Plain English

Inclusion Criteria: * ASA (American Society of Anesthesiology) class I-IV * age 18-75. Exclusion Criteria: * ASA class V * morbid obesity * patient refusal * patients with chronic pain or on pain medication * allergy to LA * patients receiving any additional regional techniques * coagulopathy * patients receiving systemic anticoagulation * local infection and procedures anticipated to last more than 5 hours.

Locations (1)

Icahn School of Medicine at Mount Sinai

New York, New York, United States

Outcomes

Primary Outcomes

Narcotic Consumption

Narcotic consumption in the first 24 hours

Time frame: 24 hours

Secondary Outcomes

Visual Analogue Score (VAS) for Pain

Visual Analogue Score (VAS) for pain - scored from 0 (no pain) to 10 (extreme pain), that is, higher score indicates more pain.

Time frame: at 6, 12, 18, and 24 hours post procedure

Time to First Dose of Narcotic Administration

Time frame: up to 24 hours

PACU Length of Stay

Post-Anesthesia Care Unit (PACU) length of stay (LOS)

Time frame: average 24 hours

Number of Participants With Pain by Location

Location of knee pain as anterior/posterior, medial/lateral

Time frame: 24 hours

Ambulation Distance

Ambulation distance with assistance on Post-operative Day (POD) 1 as assessed by PT

Time frame: Post-op Day 1

Bartels Index

Bartels Index to measure activities of daily living (ADL's) on POD 1 as assessed by OT. Total possible scores range from 0-100, with higher scores indicating more independence.

Time frame: Post-op Day 1

Data from ClinicalTrials.gov

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