Comparison of Combination of Proximal ACB and iPACK With Large-Volume Distal ACB for Early Mobilization After TKR

Indonesia University30 enrolled

Overview

Large-volume distal ACB is not superior to combination of proximal ACB and iPACK in facilitating early mobilization after TKR. Block performing time of distal ACB was significantly shorter compared to the combination of proximal ACB and iPACK

Adductor Canal Block (ACB) and Infiltration between Popliteal Artery and Capsule of Knee (iPACK) are popular block methods for analgesia after Total Knee Replacement (TKR), covering both anterior and posterior knee. Adductor canal serves as a passageway, local anesthetic injected here will spread both to proximal and distal to posterior. Study was a single-blinded, randomized controlled trial between June 2023 and January 2024. Large-volume distal ACB is not superior to combination of proximal ACB and iPACK in facilitating early mobilization after TKR. Block performing time of distal ACB was significantly shorter compared to the combination of proximal ACB and iPACK

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

SINGLE

Enrollment

Conditions

Adductor Canal Block Postoperative Pain Regional Anesthesia

Interventions

Regional AnesthesiaPROCEDURE

The interventions are three different regional anesthesia techniques: Proximal Adductor Canal Block (ACB), iPACK (Interspace between the Popliteal Artery and the Capsule of the Posterior Knee), and Large-Volume Distal Adductor Canal Block (Large ACB distal). all three interventions were administered using ropivacaine 0.2%. However, there were differences in the volumes injected for each regional anesthesia technique. Proximal ACB: 15 mL of ropivacaine 0.2%. iPACK: 20 mL of ropivacaine 0.2%. Large ACB distal: 35 mL of ropivacaine 0.2%

Eligibility

Sex: ALL

Medical Language ↔ Plain English

Inclusion Criteria: * Patients aged 50 - 80 years who underwent total knee replacement surgery Exclusion Criteria: * Systemic allergy, anaphylactic reaction, and occurrence of cardiac arrest * Intraoperative fracture * Change to general anesthesia * Patient who decides to withdraw from the study.

Locations (1)

Cipto Mangunkusumo Hospital, Jakarta Pusat, DKI Jakarta, Indonesia

Jakarta Pusat, DKI Jakarta, Indonesia

Outcomes

Primary Outcomes

Timed Up and Go test on Postoperative Day 1 (POD 1)

The Timed Up and Go (TUG) test is a functional mobility assessment used to evaluate a person's ability to stand up from a chair, walk a short distance, turn around, return to the chair, and sit down again. It assesses balance, gait, and functional mobility, which are crucial aspects of postoperative recovery.

Time frame: The test is conducted specifically on the first day after the surgery, known as Postoperative Day 1 (POD 1)

Numeric Rating Scale

The NRS is a commonly used tool to assess pain intensity. Patients are typically asked to rate their pain on a numerical scale from 0 to 10, where 0 represents no pain and 10 represents the worst imaginable pain

Time frame: The NRS assessments are conducted at 6 hours, 12 hours, and 24 hours after the surgery

Total 24 hours morphine consumption

This measures the total amount of morphine consumed by patients within the first 24 hours after surgery. It reflects the effectiveness of pain management strategies and the need for opioid analgesia

Time frame: The measurement is taken over the entire 24-hour period following the surgery

Data from ClinicalTrials.gov

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