IPACK Block Versus Adductor Canal Block in High Tibeal Osteotomy

NCT ID: NCT05271188

Last Updated: 2022-03-08

Basic Information

• Recruitment Status: UNKNOWN
• Clinical Phase: NA
• Total Enrollment: 60 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 2022-03-15
• Study Completion Date: 2023-03-31

Brief Summary

A comparison between IPACK block and adductor canal block in post operative pain management

Detailed Description

Two groups of patients between 40 and 60 yrs who are undergoing open wedge high tibeal osteotomy Group 1 will receive IPACK block with 15 ml Bupivacaine, immediately before spinal anaesthesia .

Group 2 will receive adductor canal block ,also with 15 ml Bupivacaine. before spinal anaesthesia. register the time of first pain sensation and firs IV analgesic dose required in each group

Conditions

Pain, Postoperative

Study Design

• Allocation Method: NON_RANDOMIZED
• Intervention Model: PARALLEL
• Primary Study Purpose: SUPPORTIVE_CARE
• Blinding Strategy: NONE

Study Groups

Group 1 who will receive IPACK block

This group of patients will receive IPACK block immediately before spinal anaesthesia then follow up for 24 hrs to register first pain sensation and analgesic requirements

Group Type: ACTIVE_COMPARATOR

Infiltration of local anaesthetic between popliteal artery and posterior knee capsule

Intervention Type: PROCEDURE

Adductor canal block (ACB) is a popular peripheral nerve block that has been shown to decrease pain significantly and thereby opioid consumption with minimal effect on quadriceps function \[8\]. Though ACB provides analgesia to the peripatellar and intra-articular aspect of knee joint, it does not relieve posterior knee pain which is moderate to severe in intensity \[9, 10\]. The recent technique of an ultrasound (US)-guided local anesthetic infiltration of the interspace between popliteal artery and the capsule of posterior knee (IPACK) has shown to provide significant posterior knee analgesia without affecting the common peroneal nerve (CPN) \[11\]. We postulated that IPACK will provide better pain relief and improve knee function in the immediate postoperative period compared to ACB

Group 2 who will receive adductor canal block

This group of patients will receive adductor canal block immediately before spinal anaesthesia then follow up for 24 hrs to register first pain sensation and analgesic requirements

Group Type: ACTIVE_COMPARATOR

Infiltration of local anaesthetic between popliteal artery and posterior knee capsule

Intervention Type: PROCEDURE

Adductor canal block (ACB) is a popular peripheral nerve block that has been shown to decrease pain significantly and thereby opioid consumption with minimal effect on quadriceps function \[8\]. Though ACB provides analgesia to the peripatellar and intra-articular aspect of knee joint, it does not relieve posterior knee pain which is moderate to severe in intensity \[9, 10\]. The recent technique of an ultrasound (US)-guided local anesthetic infiltration of the interspace between popliteal artery and the capsule of posterior knee (IPACK) has shown to provide significant posterior knee analgesia without affecting the common peroneal nerve (CPN) \[11\]. We postulated that IPACK will provide better pain relief and improve knee function in the immediate postoperative period compared to ACB

Interventions

Infiltration of local anaesthetic between popliteal artery and posterior knee capsule

Adductor canal block (ACB) is a popular peripheral nerve block that has been shown to decrease pain significantly and thereby opioid consumption with minimal effect on quadriceps function \[8\]. Though ACB provides analgesia to the peripatellar and intra-articular aspect of knee joint, it does not relieve posterior knee pain which is moderate to severe in intensity \[9, 10\]. The recent technique of an ultrasound (US)-guided local anesthetic infiltration of the interspace between popliteal artery and the capsule of posterior knee (IPACK) has shown to provide significant posterior knee analgesia without affecting the common peroneal nerve (CPN) \[11\]. We postulated that IPACK will provide better pain relief and improve knee function in the immediate postoperative period compared to ACB

Intervention Type: PROCEDURE

Other Intervention Names

Adductor canal block

Eligibility Criteria

Inclusion Criteria

1. Age 40 - 60 years.

2. American Society of Anesthiologist class ( ASA) I - III

3. BMI 18-35 kg/m2

4. Scheduled for primary unilateral open wedge high tibial osteotomy

Exclusion Criteria

1. Known allergy to local anesthetics

2. Contraindication to local anesthetics injection e.g. infection at the site of injection

3. Contraindication to spinal anesthesia e.g. coagulopathy.

4. Patients with pre-existing motor or sensory deficits in lower extremities.

5. Insulin or noninsulin dependent diabetes mellitus.

6. systemic corticosteroid use within 30-days of surgery

7. difficulties in comprehending visual analog scale (VAS) pain scores

8. history of arrhythmia or seizures

9. severe renal insufficiency

• Minimum Eligible Age: 40 Years
• Maximum Eligible Age: 60 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: No

Sponsors

Assiut University

OTHER

Sponsor Role: lead

Responsible Party

Salwa Hussein Ahmed Hussein

Assistant lecturer

Responsibility Role: PRINCIPAL_INVESTIGATOR

Principal Investigators

Salwa Hussein, Lecturer

Role: PRINCIPAL_INVESTIGATOR

Assiut University

Central Contacts

Salwa Hussein

Role: CONTACT

salwa94hussien@gmail.com

01159460234

Abd elraheem Mahmoud

Role: CONTACT

arawamyyy@yahoo.com

01000032655

Other Identifiers

Pain control

Identifier Type: -

Identifier Source: org_study_id