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CC BY-NC-ND 4.0 · J Knee Surg
DOI: 10.1055/s-0044-1801822
Original Article

Analgesic Effect of Intermittent Multiple IPACK Block Combined with ACB in Patients with Flexion Contracture Knee Arthritis Undergoing Total Knee Arthroplasty

Yuqi Ren
1   Department of Anesthesiology, The First Hospital of Jilin University, Changchun, People's Republic of China
,
Zhouhui Hou
1   Department of Anesthesiology, The First Hospital of Jilin University, Changchun, People's Republic of China
2   Department of Anesthesiology, Tianjin Medical University Cancer Institute & Hospital, Tianjin, People's Republic of China
,
Yue Zhang
1   Department of Anesthesiology, The First Hospital of Jilin University, Changchun, People's Republic of China
,
Yue Li
1   Department of Anesthesiology, The First Hospital of Jilin University, Changchun, People's Republic of China
,
Huanqiu Liu
1   Department of Anesthesiology, The First Hospital of Jilin University, Changchun, People's Republic of China
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Abstract

We aimed to compare the analgesic effects of intermittent multiple infiltrations between the popliteal artery and capsule of the posterior knee (IPACK) combined with adductor canal block (ACB) and intermittent ACB alone in patients with flexion contracture knee arthritis undergoing total knee arthroplasty (TKA). Forty-six patients who underwent elective unilateral TKA were divided into two groups (n = 23 each): intermittent multiple IPACK combined with ACB (group IA) and intermittent multiple ACB (group A). ACB was performed with 20 mL of 0.375% ropivacaine in each group and IPACK with 20 mL of 0.25% ropivacaine in group IA. Intermittent multiple nerve blocks were used for postoperative analgesia (IPACK block combined with ACB in group IA and ACB in group A between 7:30 and 8:30 a.m. on postoperative day 1 [POD1] and postoperative day 2 [POD2]). Primary outcomes assessed were pain at rest, motion-evoked pain (MEP), and range of motion (ROM) on POD1 and POD2. Secondary outcomes included opioid consumption, first ambulation time, ambulation distance, and postoperative complications. We observed that compared with group A, MEP decreased, ROM became wider, ambulation distance was longer, and opioid consumption decreased in group IA. Other outcomes were either similar between the groups or showed clinically insignificant differences. We conclude that multiple intermittent IPACK therapy combined with ACB provides superior analgesia than multiple intermittent ACB therapy alone in patients with flexion contracture knee arthritis undergoing TKA.

Keywords

IPACK - adductor canal block - total knee arthroplasty - flexion contracture - postoperative analgesia


Publication History

Received: 15 October 2024

Accepted: 10 December 2024

Article published online:
20 January 2025

© 2025. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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