Effect of Continuous Adductor Canal Block Versus Continuous Adductor Canal Block With Additional Infiltration Between The Popliteal Artery and Capsule of The Knee (IPACK) After Arthroscopic Knee Surgeries

Ain Shams University70 enrolled

Overview

This study aims to evaluate the effect of Continuous Adductor Canal Block only versus adding posterior knee block, known as the Infiltration between the Popliteal Artery and Capsule of the Knee (IPACK) block with Continuous Adductor Canal Block (CACB) after arthroscopic knee surgeries.

Enhanced recovery after arthroscopic knee surgery is gaining popularity in orthopedic surgeries. Motor preservation with adequate analgesia has become the optimal postoperative goal, enabling earlier physical therapy, faster recovery, and early hospital discharge. Spinal anesthesia for knee arthroscopy has favorable outcome effects compared with general anesthesia. The positive physiological effects of the provided sympathetic blockade with less blood loss, increased leg blood flow, and better initial pain relief explain this. An ideal nerve block that targets the sensory nerves and spares the motor function can facilitate early ambulation and rehabilitation, a major goal for patients undergoing arthroscopic knee surgery. A novel technique for posterior knee block, known as the infiltration between the popliteal artery and capsule of the knee (IPACK) block combined with continuous adductor canal block (CACB) would reduce opioid requirements.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

DOUBLE

Enrollment

Conditions

Continuous Adductor Canal Block

Eligibility

Sex: ALLMin age: 21 YearsMax age: 65 Years

Medical Language ↔ Plain English

Inclusion Criteria: * Age from 21 to 65 years. * Both sexes. * American Society of Anesthesiologists (ASA) Physical Status Class I to II. * Patients with successful spinal anesthesia. * Patients scheduled for elective arthroscopic knee surgery for anterior cruciate ligament (ACL) and posterior cruciate ligament (PCL) repair. Exclusion Criteria: * Declining to give written informed consent. * History of allergy to the medications used in the study. * Contraindications to regional anesthesia (including coagulopathy and local infection). * Polytrauma patients having lower limb fractures. * Patients with pre-existing myopathy or neuropathy on the operating limb. * Patients with diabetes mellitus. * Psychiatric disorder. * Morbid obesity \[body mass index (BMI) \> 45kg/m2\]. * Complicated Surgery.

Outcomes

Primary Outcomes

Degree of pain

The degree of pain will be assessed using the Visual Analogue Scale (VAS). VAS score is determined by measuring the distance (mm) on the 10-cm line between the "no pain" anchor and the patient's mark, providing a range of scores from 0-100. No pain (0-4 mm), mild pain (5-44 mm), moderate pain (45-74 mm), and severe pain (75-100 mm).