IPACK Block Versus Adductor Canal Block in High Tibeal Osteotomy

March 6, 2022 updated by: Salwa Hussein Ahmed Hussein, Assiut University

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

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

Study Overview

Status

Not yet recruiting

Conditions

Intervention / Treatment

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 Type

Interventional

Enrollment (Anticipated)

60

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Contact

Study Contact Backup

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

36 years to 56 years (Adult)

Accepts Healthy Volunteers

No

Genders Eligible for Study

All

Description

Inclusion Criteria:

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

Exclusion Criteria:

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

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Supportive Care
  • Allocation: Non-Randomized
  • Interventional Model: Parallel Assignment
  • Masking: None (Open Label)

Arms and Interventions

Participant Group / 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

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
the time of first pain sensation requiring analgesia
Time Frame: 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
24 hours

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Assiut University

Investigators

  • Principal Investigator: Salwa Hussein, Lecturer, Assiut University

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Anticipated)

March 15, 2022

Primary Completion (Anticipated)

February 1, 2023

Study Completion (Anticipated)

March 1, 2023

Study Registration Dates

First Submitted

February 14, 2022

First Submitted That Met QC Criteria

March 6, 2022

First Posted (Actual)

March 8, 2022

Study Record Updates

Last Update Posted (Actual)

March 8, 2022

Last Update Submitted That Met QC Criteria

March 6, 2022

Last Verified

March 1, 2022

More Information

Terms related to this study

Additional Relevant MeSH Terms

Other Study ID Numbers

  • Pain control

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

No

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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