Combined ACB and IPACK block significantly improved postoperative VAS scores, time to first rescue analgesia, and total narcotics intake compared to ACB alone or spinal anesthesia (P<0.001).
RCT (n=60)
Double-blinded
Randomized
Does the combination of ACB and IPACK block improve postoperative analgesia compared to ACB alone or spinal anesthesia alone in patients undergoing total knee arthroplasty?
Combined ACB and IPACK block provides more effective postoperative analgesia than ACB alone or spinal anesthesia alone in patients undergoing total knee arthroplasty.
p-value: p=<0.001
Background Group B underwent ultrasound guided ACB after spinal anesthesia, and Group C was administered a blend of ACB and IPACK block under ultrasound guidance at the commencement of the surgery. Postoperatively, pain levels were evaluated using VAS scores. If the VAS score exceeded 4, 50 mg of intravenous pethidine was used as a primary rescue analgesic to lower the VAS score to below 3. Results: Demographic data and preoperative hemodynamic parameters (heart rate and mean arterial blood pressure) were equivalent in both groups. Postoperatively, HR at 4, 8, 12 and 24 h and MAP at 12 and 24 h were significantly different (P < 0.001). Time to first rescue analgesia, total narcotics intake and VAS scores were significantly different at 4, 8, 12 and 24 h (P < 0.001). Conclusion: In patients undergoing TKA, postoperative analgesia of combined ACB and IPACK was more effective than that of ACB block alone regarding hemodynamic changes, pain scores, doses of pethidine required for pain relief and postoperative mobilization. Keywords: Adductor Canal Block; IPACK; Knee Arthroplasty; Knee Capsule; Nerve Block Citation: Taha Abdelghaffar MR, Nemr MM, Mohamed Mabrouk MH, Elgendy HMA, Abdulmageed AM. A comparative study between the analgesic effect of adductor canal block with or without IPACK block after total knee arthroplasty. Anaesth. pain intensive care 2025;29(2):242-247. DOI: 10.35975/apic.v29i2.2710 Received: October 10, 2024; Reviewed: October 31, 2024; Accepted: December 28, 2024
Abdel-Ghaffar et al. (Thu,) conducted a rct in Postoperative pain following total knee arthroplasty (n=60). Combined Adductor Canal Block (ACB) and IPACK block vs. Spinal anesthesia alone or ACB alone was evaluated on VAS scores, time to first rescue analgesia, and total narcotics intake (p=<0.001). Combined ACB and IPACK block significantly improved postoperative VAS scores, time to first rescue analgesia, and total narcotics intake compared to ACB alone or spinal anesthesia (P<0.001).