IPACK Block Multimodal Analgesia, Postoperative NRS Scores
Conditions
Brief summary
A comparison of two pain control methods - the combination of Adductor Canal Block (ACB)/Infiltration of the interspace between the popliteal artery and the capsule of the posterior knee (IPACK) versus the Periarticular Injection (PAI)/ Infiltration of the interspace between the popliteal artery and the capsule of the posterior knee (IPACK) - in patients undergoing total knee arthroplasty. dexketoprofen and paracetamol will be added to both groups and multimodal analgesia will be applied. Primary outcome is NRS pain scores with ambulation on postoperative day one (24 hours post-block administration).
Detailed description
Postoperative pain after total knee arthroplasty is serious and difficult to management. Multimodal analgesia recommended for the pain management. For these reasons, we planned a study involving two multimodal analgesia regimens. Patients who will undergo total knee arthroplasty will receive preemptive oral analgesic (dexketofrofen) 1 hour before the operation. Surgery will be initiated after spinal anesthesia is applied to the patients. Two pain control methods - the combination of Adductor Canal Block (ACB)/Infiltration of the interspace between the popliteal artery and the capsule of the posterior knee (IPACK) versus the Periarticular Injection (PAI)/ IPACK- will be applied at the end of the surgery. dexketoprofenand paracetamol will be added to both groups and multimodal analgesia will be applied. Primary outcome is NRS pain scores with ambulation on postoperative day one (24 hours post-block administration).
Interventions
Sponsors
Ankara Diskapi Training and Research Hospital
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
NONE
Intervention model description
Power analysis will be done after a pilot study. Number of patient may vary.
Eligibility
Sex/Gender
ALL
Age
18 Years to 80 Years
Healthy volunteers
Yes
Inclusion criteria
* Patients with osteoarthritis scheduled for a primary either partial or total knee arthroplasty with a participating surgeon * Age 18 to 80 years * Planned use of regional anesthesia * Ability to follow study protocol * Patients of participating surgeons
Exclusion criteria
* Hepatic or renal insufficiency * Younger than 18 years old and older than 80 * Patients undergoing general anesthesia * Allergy or intolerance to one of the study medications * BMI \> 40 * Diabetes * ASA of IV * Chronic gabapentin/pregabalin use (regular use for longer than 3 months) * Chronic opioid use (taking opioids for longer than 3 months, or daily oral morphine equivalent of \>5mg/day for one month)
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| NRS Pain Scores | 24 hours post block administration | NRS Pain scores with ambulation 24 hours post block administration.All patients' postoperative pain numerical rating scale (NRS-numeric rating scale; 0 = absence of pain, 10 = unbearable pain) will be recorded in both groups. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| NRS at Rest and with movement | 24 hours on Post-Operative Day 1 | NRS at rest and with movement at different intervals. All patients' postoperative pain numerical rating scale (NRS-numeric rating scale; 0 = absence of pain, 10 = unbearable pain) will be recorded in both groups. |
| Patient Satisfaction with Pain Control using the likert scale | Post-Operative 24 hours | Satisfaction with Pain control at different intervals. 1-5 (according to patient satisfaction) |
Countries
Turkey (Türkiye)
Contacts
Primary Contactilkay MD Baran akkus, MD
Outcome results
None listed