IPACK Block Versus Adductor Canal Block in High Tibeal Osteotomy

Sponsor

Assiut University (Other)

Overall Status

Not yet recruiting

CT.gov ID

NCT05271188

Collaborator

(none)

Enrollment

Arms

11.5

Anticipated Duration (Months)

Study Details

Study Description

Brief Summary

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

Condition or Disease	Intervention/Treatment	Phase
Pain, Postoperative	Procedure: Infiltration of local anaesthetic between popliteal artery and posterior knee capsule	N/A

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

Study Design

Study Type:

Interventional

Anticipated Enrollment :

60 participants

Allocation:

Non-Randomized

Intervention Model:

Parallel Assignment

Intervention Model Description:

Two groups of people who are undergoing open wedge high tibeal osteotomy aged between 40 and 60 yrs old not diabetic and neurologically freeTwo groups of people who are undergoing open wedge high tibeal osteotomy aged between 40 and 60 yrs old not diabetic and neurologically free

Masking:

None (Open Label)

Primary Purpose:

Supportive Care

Official Title:

Infiltration of Local Anesthetic in the Interspace Between the Popliteal Artery and Capsule of the Posterior Knee "IPACK Block" Versus Adductor Canal Block "ACB" for Pain Relief After Open Wedge High Tibial Osteotomy

Anticipated Study Start Date :

Mar 15, 2022

Anticipated Primary Completion Date :

Feb 1, 2023

Anticipated Study Completion Date :

Mar 1, 2023

Arms and Interventions

Arm	Intervention/Treatment
Active Comparator: 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	Procedure: 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 Other Names: Adductor canal block
Active Comparator: 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	Procedure: 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 Other Names: Adductor canal block

Arm

Intervention/Treatment

Active Comparator: 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

Procedure: 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

Other Names:

Adductor canal block

Active Comparator: 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

Procedure: Infiltration of local anaesthetic between popliteal artery and posterior knee capsule

Other Names:

Adductor canal block

Outcome Measures

Primary Outcome Measures

the time of first pain sensation requiring analgesia [24 hours]
If intervention which is adductor canal block or lPACK block is effective in postoperative pain control that can decrease the lV analgesic agents

Eligibility Criteria

Criteria

Ages Eligible for Study:

40 Years to 60 Years

Sexes Eligible for Study:

All

Accepts Healthy Volunteers:

Inclusion Criteria:

Age 40 - 60 years.
American Society of Anesthiologist class ( ASA) I - III
BMI 18-35 kg/m2
Scheduled for primary unilateral open wedge high tibial osteotomy

Exclusion Criteria:

Known allergy to local anesthetics
Contraindication to local anesthetics injection e.g. infection at the site of injection
Contraindication to spinal anesthesia e.g. coagulopathy.
Patients with pre-existing motor or sensory deficits in lower extremities.
Insulin or noninsulin dependent diabetes mellitus.
systemic corticosteroid use within 30-days of surgery
difficulties in comprehending visual analog scale (VAS) pain scores
history of arrhythmia or seizures
severe renal insufficiency

Contacts and Locations

Locations

No locations specified.

Sponsors and Collaborators

Assiut University

Investigators

Principal Investigator: Salwa Hussein, Lecturer, Assiut University

Study Documents (Full-Text)

None provided.

More Information

Publications

None provided.

Responsible Party:

Salwa Hussein Ahmed Hussein, Assistant lecturer, Assiut University

ClinicalTrials.gov Identifier:

NCT05271188

Other Study ID Numbers:

Pain control

First Posted:

Mar 8, 2022

Last Update Posted:

Mar 8, 2022

Last Verified:

Mar 1, 2022

Individual Participant Data (IPD) Sharing Statement:

Plan to Share IPD:

Studies a U.S. FDA-regulated Drug Product:

Studies a U.S. FDA-regulated Device Product:

Additional relevant MeSH terms:

Pain, Postoperative

Anesthetics

Anesthetics, Local

Study Results

No Results Posted as of Mar 8, 2022