Effect of Adding Ultrasound Guided IPACK Block to Adductor Canal Block for Postoperative Pain in Knee Tumor Excision
For patients and families
In plain language
An automatic summary of structured registry data. It is an orientation aid, not a substitute for the official protocol or a physician assessment.
- What is being studied
- The protocol lists: adductor canal block with iPACK, control group.
- Who it may be relevant to
- Registry conditions: Cancer Pain. Basic parameters: 18 years — 65 years · All.
- What needs checking
- Age, condition and sex are only basic indicators. Prior treatment, laboratory values and other mandatory requirements appear in the eligibility criteria below.
- Where it takes place
- Egypt
- Next step
- Save the trial, show it to the treating physician, and confirm current recruitment with the study center. Costs, documents and travel →
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Official title
Analgesic Efficacy of Adding Ultra Sound Guided IPACK Block to Adductor Canal Block for Postoperative Pain Management After Excision of Tumors Around Knee: a Randomized Controlled Trial
Overview
the aim of this study is to determine the analgesic effect of iPACK in combination to ACB after the excision of tumors around the Knee regarding the following: * Time to the 1st rescue analgesia. * Postoperative morphine consumption. * Postoperative visual analogue scale (VAS). This study will include patients, aged 18 to 65 years, belonging to the American Society of Anesthesiologists (ASA) physical status II to IV , undergoing excision of tumors around the knee under spinal anesthesia. Patients will be randomly allocated Group iPACK plus Adductor canal block (ACB) : patients will receive ACB plus iPACK block. • Control group : patients will not receive any block but will take morphine 3mg bolus at VAS more than 4 and regular NSAIDS and paracetamol iv.
Detailed description
Immediate alleviation of postoperative pain after knee surgeries is critical for patients' postoperative recovery. Ineffective pain management may result in an extended hospital stay and rehabilitation period, as well as the development of chronic pain Non-opioid analgesics are insufficient to alleviate the pain that is intended to be relieved.
Although using Opioids have concerns regarding their potential side effects, which encompass nausea, vomiting, respiratory depression, and addiction Multimodal analgesia, which may include preemptive analgesia, neuraxial blockade, peripheral nerve block, and narcotic and non-narcotic analgesics, is an optimal approach for the management of acute pain following knee surgeries Adductor canal block (ACB) is an interfascial plane infiltration of local anesthetic used to block a portion of the saphenous nerve, which originates in the adductor canal, as well as the obturator nerve ACB combined with an iPACK block results in significantly better postoperative visual analog scale (VAS) scores, knee ranges of motion, as well as ambulation distances compared with ACB alone
Interventions
- Procedure adductor canal block with iPACK
The adductor canal will be identified. a spinal needle 22 gauge x 3.5 inches will be advanced with the guidance of ultrasound in an in-plane technique ,and 15ml of 0.5% bupivacaine will be injected then IPACK block will be performed. The probe will be applied to the popliteal fossa for identification of the popliteal artery and femur. Then, the probe will be slid distally for revealing the two femoral condyles followed by proximal sliding of the probe until the humps of the femoral condyles disa - Other control group
The probe will be positioned at the midpoint between the anterior superior iliac spine and the upper pole of the patella. The adductor canal, which is a hyperechoic structure situated beneath the sartorius muscle, will be identified but no block will be done
Primary outcome measures
- Time to the 1st rescue analgesia [Time frame: 24 hours postoperative]
Secondary outcome measures (2)
- Total morphine consumption [Time frame: first 24 hour]
- pain score ( visual analogue scale) [Time frame: at 2 hours ,4 hours,6 hours, 12 hours,18 hours and 24 h postoperatively]
Eligibility criteria
Inclusion criteria
- Stated willingness to comply with all study procedures and availability for the duration of the study
- American Society of Anesthesiologists (ASA) physical status II-IV.
- Patients undergoing excision of tumors around the knee under spinal anesthesia
Exclusion criteria
- Patient refusal.
- Neuromuscular disorders
- Allergy to local anesthetics
- Previous history of knee surgery
- Patients with a prior knee infection
- Contraindications to spinal anesthesia as coagulopathies and severe aortic stenosis.
Criteria are shown verbatim from the registry (in English). Final eligibility is always assessed by the study center.
Healthy volunteers: No
Study design
- Allocation
- Randomized
- Model
- Parallel assignment
- Masking
- Double blind
- Primary purpose
- Prevention
Study locations
Egypt · 1 center
- National cancer institute — Cairo
Identifiers
NCT: NCT07382297 · AP2407-201-011