Continuous Adductor Canal Block, Infiltration Between The Popliteal Artery and Capsule of The Knee, Arthroscopic Knee Surgeries
Conditions
Brief summary
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.
Detailed description
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.
Interventions
Patients will receive continuous adductor canal block.
OTHERContinuous Adductor Canal Block with additional Infiltration between The Popliteal Artery and Capsule
Patients will receive Continuous Adductor Canal Block with additional Infiltration between The Popliteal Artery and Capsule of The Knee
Sponsors
Ain Shams University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
DOUBLE (Subject, Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
21 Years to 65 Years
Healthy volunteers
No
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.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Degree of pain | 24 hours postoperatively | 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). |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Total Nalbuphine consumption | 24 hours postoperatively | Rescue analgesia will be given when VAS score ≥ 30 mm, in the form of IV injection of 10 mg Nalbuphine. Followed by reassessment of pain after 10 minutes, a second dose of Nalbuphine will be given if still VAS score ≥ 30 mm. |
| Straight leg rise | 24 hours postoperatively | Straight leg rise (SLR) will be recorded. |
| Range of motion | 24 hours postoperatively | Range of motion (ROM) will be recorded |
| Rate of complications | 24 hours postoperatively | Rate of complications like falling will be recorded |
Countries
Egypt
Contacts
Primary ContactNada E Hussein, Master
Outcome results
None listed