Pain Management After Adductor Canal Block for Total Knee Arthroplasty

Pain Management and Functional Recovery After Adductor Canal Block Combined With iPACK Block for Total Knee Arthroplasty. A Prospective, Randomized, Double-blinded Clinical Trial.

Status

Completed

Phases

Phase 4

Study type

Interventional

Source

ClinicalTrials.gov

Registry ID

NCT06086483

Enrollment

361

Registered

2023-10-17

Start date

2020-06-18

Completion date

2023-08-24

Last updated

2023-10-17

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

Knee Osteoarthritis, Knee Arthritis, Knee Arthropathy, Knee Pain Chronic

Keywords

iPACK, Adductor Canal Block, pain management, multimodal analgesia, peripheral nerve block, knee arthroplasty

Brief summary

This randomized, double-blinded, placebo-controlled trial sought to evaluate the efficacy of the iPACK block with Adductor Canal Block on postoperative pain, functional recovery and NLR and PLR levels.

Detailed description

The Interspace between the popliteal artery and capsule of the posterior knee, or iPACK block, together with the Adductor Canal block (ACB), has been described and shows promise in providing analgesia to the knee joint. However, the effect of these two blocks on postoperative pain levels, functional recovery, and stress response is uncertain. This study compares a preoperative iPACK and ACB block to Sham blocks before total knee arthroplasty under spinal anesthesia.

Interventions

DRUGRopivacaine 0.2% Injectable Solution

20 mL 0.5% ropivacaine was injected into the PENG block 20 mL 0.5% ropivacaine was injected into the Adductor Canal block

DRUG0.9%sodium chloride

20 mL 0.9% sodium chloride was injected into the PENG block 20 mL 0.5% sodium chloride was injected into the Adductor Canal block

Study design

Allocation

RANDOMIZED

Intervention model

PARALLEL

Primary purpose

TREATMENT

Masking

TRIPLE (Subject, Caregiver, Investigator)

Intervention model description

randomized, double-blind, placebo-controlled

Eligibility

Sex/Gender

ALL

Age

18 Years to 100 Years

Healthy volunteers

Inclusion criteria

* Patients \> 18 years old undergoing unilateral total knee arthroplasty

Exclusion criteria

* refusal to participate * \< 18 yo * Chronic opioid use * localized infection

Design outcomes

Primary

Measure	Time frame	Description
postoperative Numeric Pain Rating Scale during active flexion	48 hours after surgery	Numeric Pain Rating Scale. The 11-point numeric scale ranges from '0' representing one pain extreme (e.g. no pain) to '10' representing the other pain extreme (e.g. pain as bad as you can imagine or worst pain imaginable)
postoperative Numeric Pain Rating Scale	24 hours after surgery	Numeric Pain Rating Scale. The 11-point numeric scale ranges from '0' representing one pain extreme (e.g. no pain) to '10' representing the other pain extreme (e.g. pain as bad as you can imagine or worst pain imaginable)
postoperative Numeric Pain Rating Scale et rest	48 hours after surgery	Numeric Pain Rating Scale. The 11-point numeric scale ranges from '0' representing one pain extreme (e.g. no pain) to '10' representing the other pain extreme (e.g. pain as bad as you can imagine or worst pain imaginable)

Secondary

Measure	Time frame	Description
Postoperative opioid consumption	96 hours after surgery	milligrams of intravenous morphine equivalents
Time to first opioid administration	96 hours postoperatively	Hours to first administration of an intravenous opioid drug
Neutrophil-to-lymphocyte ratio	12 hours after surgery	Neutrophil-to-lymphocyte ratio
Platelet-to-lymphocyte ratio	12 hours after surgery	Platelet-to-lymphocyte ratio

Countries

Poland

Outcome results

None listed

Source: ClinicalTrials.gov · Data processed: Feb 4, 2026