Post Operative Pain
Conditions
Brief summary
Comparative Study between Adductor canal block combined with infiltration OF The interspace between popliteal artery and the capsule of the knee block versus genicular nerves Block combined with IPACK in Postoperative analgesia after knee replacement surgery
Detailed description
Patient informed written consent and ethical committee approval of Faculty of Medicine; Ain Shams University will be obtained before patient allocation. • Study procedures: Supervisors and experts will do all the study procedures. Patients undergoing unilateral Total knee replacement (TKR) will be randomly assigned into one of the following groups using computer generated codes (15 patients in each group): Group 1 (ACB - IPACK group): will receive spinal anesthesia and ultrasound-guided Adductor canal nerve block, as well as infiltration of the space between the popliteal artery and the capsule of the posterior knee (IPACK) block. Group 2 (GNB - IPACK group): will recieve spinal anesthesia and US guided Genicular nerves block and IPACK block.
Interventions
PROCEDUREACB - IPACK
will receive spinal anesthesia and ultrasound-guided Adductor canal nerve block, as well as infiltration of the space between the popliteal artery and the capsule of the posterior knee (IPACK) block.
PROCEDUREGNB - IPACK
will recieve spinal anesthesia and US guided Genicular nerves block and IPACK block.
Sponsors
Ain Shams University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
OTHER
Masking
SINGLE (Subject)
Eligibility
Sex/Gender
ALL
Age
30 Years to 85 Years
Healthy volunteers
Yes
Inclusion criteria
* Age 30-85 years. * Both sexes. * American Society of Anesthesiologists (ASA) Physical Status Class I to III. * Patients scheduled for unilateral TKA under spinal anesthesia.
Exclusion criteria
* Patient's refusal. * American Society of Anesthesiologists (ASA) Physical Status Class above III. * local infection. * History of allergy to the medications used in the study. 5. Psychiatric disorder.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| 1- Comparing both groups regarding the time needed ( in hours) for the first call rescue analgesia post operatively. | 5 minutes after ending of operation | Total knee replacement (TKR) is a well-known popular surgical procedure for knee diseases, including end-stage knee osteoarthritis that causes severe postoperative pain and prolonged immobility. Acute pain control can be provided with multimodal analgesia, including non-steroidal anti-inflammatory drugs (NSAIDs) and opioids. However, NSAIDs cause many side effects as peptic ulcer and gastritis, also opioids have gastrointestinal side effects as constipation, nausea and vomiting as well as respiratory depression. Regional analgesia has been used as another modality to provide sufficient perioperative pain relief with minimal opioid consumption to avoid it's adverse effects peripheral nerve blocks (PNBs) is a common practice in orthopedic surgery. PNBs provide excellent pain management after TKA, promote early mobilization, and reduce the consumption of opioids, the incidence of opioid-related adverse effects, and the hospital stay |
Countries
Egypt
Outcome results
None listed