Comparison of Distal IPACK and Popliteal Plexus Block Combined With Femoral Triangle Block After Total Knee Arthroplasty

Popliteal Plexus Block (PPB) is a new nerve block technique that has been shown to anaesthetise nerves involved in the innervation of the posterior part of the knee joint.

The IPACK (interspace between the popliteal artery and capsule of the posterior knee) block is a regional anesthesia technique in which a local anesthetic is infiltrated under ultrasound guidance between the popliteal artery and the capsule of the posterior knee. This technique blocks the branches of the obturator nerve, the common peroneal nerve, and the tibial nerve in the popliteal region. In the context of knee arthroplasty, the application of the IPACK block has been associated with lower scores for ambulatory pain, lower scores for resting pain, and reduced morphine consumption.

Although both techniques of blockade seem to be efficient in the context of analgesia for the posterior part of the knee after TKA. No study compares these two blocks as part of multimodal analgesia to provide pain relief after TKA.

This study aimed to evaluate the analgesic effect of PPB or distal IPACK, in addition to femoral triangle block, as a component of a multimodal analgesic regimen after TKA.

• NRS scores [Срок оценки: 48 hours]
• Range of knee motion [Срок оценки: 48 hours]
• Patient mobilization [Срок оценки: 48 hours]
• Post-block Maximum Voluntary Isometric Contraction (MVIC) by knee extension, calculated as a percentage of the Pre-block baseline value [Срок оценки: A 60-minute interval is between pre-block and post-block MVIC assessments]
• Post-block MVIC by ankle plantarflexion, calculated as a percentage of the Pre-block baseline value [Срок оценки: A 60-minute interval is between pre-block and post-block MVIC assessments]
• Post-block MVIC by ankle dorsiflexion, calculated as a percentage of the Pre-block baseline value [Срок оценки: A 60 minutes interval is between pre-block and post-block MVIC assessments]
• Muscle strength of knee extension, graded by Manual Muscle Test (MMT) [Срок оценки: Assessed pre-block, post-block (60 minutes after pre-block), and postoperative 5 hours]
• Muscle strength of ankle plantarflexion, graded by MMT [Срок оценки: Assessed pre-block, post-block (60 minutes after pre-block) and postoperative 5 hours]
• Muscle strength of ankle dorsiflexion, graded by MMT [Срок оценки: Assessed pre-block, post-block (60 minutes after pre-block) and postoperative 5 hours]
• Incidence of rebound pain [Срок оценки: Postoperative 24 hours]
• Quality of Recovery 15 Score [Срок оценки: Postoperative Day 1]