Background: Appropriate perioperative pain management, involving the utilisation of multimodal analgesia regimens combining regional anaesthesia and systemic analgesics, is crucial for optimizing functional results in individuals undergoing total knee arthroplasty (TKA).
Objective: To evaluate the efficacy of an interspace between the popliteal artery and capsule of the knee (IPACK) block supplementing Adductor Canal Block (ACB) against ACB and Periarticular Injection (PAI) blocks on postoperative pain scale scores, usage of opioid medications, and early physical therapy effectiveness in patients subjected to TKA.
Patients and Methods: In the current prospective, randomized, comparative clinical trial, 40 individuals undergoing TKA were arbitrarily distributed in two groups. Group (A) comprises individuals undergoing ultrasound-guided ACB plus IPACK block; Group (B) comprises patients undergoing both ACB and PAI block at the beginning of the surgical procedure.
Results: The ACB + IPACK group exhibited notably lower values in the VAS score (p < 0.05) compared to both the ACB group and the PAI group. Group A consumed 67.5±21.6 mg of pethidine overall over the first 48 hours, while group B consumed 87.5±33.9 mg of pethidine. The range of movement of the knee and walking distance also revealed that group A's values were considerably higher than those of group B.
Conclusion: The utilisation of both ACB and IPACK provides an improved analgesic effect than ACB and PAI while simultaneously preserving the knee joint motor power within the postoperative period.
Key words: Keywords: TKA, total knee arthroplasty; ACB, adductor canal block; IPACK, interspace between the popliteal artery and capsule of the knee; PAI, peri-articular injection.
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