Effect of Continuous Adductor Canal Block Versus Continuous Adductor Canal Block With Additional Infiltration Between The Popliteal Artery and Capsule of The Knee (IPACK) After Arthroscopic Knee Surgeries

A Comparative Study Between the Effect of Continuous Adductor Canal Block Versus Continuous Adductor Canal Block With Additional Infiltration Between The Popliteal Artery and Capsule of The Knee (IPACK) After Arthroscopic Knee Surgeries

This study aims to evaluate the effect of Continuous Adductor Canal Block only versus adding posterior knee block, known as the Infiltration between the Popliteal Artery and Capsule of the Knee (IPACK) block with Continuous Adductor Canal Block (CACB) after arthroscopic knee surgeries.

Study Overview

• Status: Recruiting
• Conditions: Continuous Adductor Canal Block; Infiltration Between The Popliteal Artery and Capsule of The Knee; Arthroscopic Knee Surgeries
• Intervention / Treatment: Other: Continuous adductor canal block; Other: Continuous Adductor Canal Block with additional Infiltration between The Popliteal Artery and Capsule

Detailed Description

Enhanced recovery after arthroscopic knee surgery is gaining popularity in orthopedic surgeries. Motor preservation with adequate analgesia has become the optimal postoperative goal, enabling earlier physical therapy, faster recovery, and early hospital discharge. Spinal anesthesia for knee arthroscopy has favorable outcome effects compared with general anesthesia. The positive physiological effects of the provided sympathetic blockade with less blood loss, increased leg blood flow, and better initial pain relief explain this.

An ideal nerve block that targets the sensory nerves and spares the motor function can facilitate early ambulation and rehabilitation, a major goal for patients undergoing arthroscopic knee surgery.

A novel technique for posterior knee block, known as the infiltration between the popliteal artery and capsule of the knee (IPACK) block combined with continuous adductor canal block (CACB) would reduce opioid requirements.

• Study Type: Interventional
• Enrollment (Estimated): 70
• Phase: Not Applicable

Contacts and Locations

• Study Contact: Name: Nada E Hussein, Master; Phone Number: 00201112449418; Email: Nadahussein@med.asu.edu.eg

Study Locations

• Egypt
  • Cairo, Egypt, 11591
    • Recruiting
    • Ain Shams University
    • Contact: Nada E Hussein, Master; Phone Number: 00201112449418; Email: Nadahussein@med.asu.edu.eg
    • Sub-Investigator: Mohamed H Shokier, MD
    • Sub-Investigator: Waleed Abdalla, MD
    • Sub-Investigator: Mohamed O Teaima, MD
    • Sub-Investigator: Mohamed S Ahmed, MD

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: No

Description

Inclusion Criteria:

• Age from 21 to 65 years.
• Both sexes.
• American Society of Anesthesiologists (ASA) Physical Status Class I to II.
• Patients with successful spinal anesthesia.
• Patients scheduled for elective arthroscopic knee surgery for anterior cruciate ligament (ACL) and posterior cruciate ligament (PCL) repair.

Exclusion Criteria:

• Declining to give written informed consent.
• History of allergy to the medications used in the study.
• Contraindications to regional anesthesia (including coagulopathy and local infection).
• Polytrauma patients having lower limb fractures.
• Patients with pre-existing myopathy or neuropathy on the operating limb.
• Patients with diabetes mellitus.
• Psychiatric disorder.
• Morbid obesity [body mass index (BMI) > 45kg/m2].
• Complicated Surgery.

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: Double

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Group 1; Patients will receive continuous adductor canal block.	Other: Continuous adductor canal block; Patients will receive continuous adductor canal block.
Experimental: Group 2; Patients will receive Continuous Adductor Canal Block with additional Infiltration between The Popliteal Artery and Capsule of The Knee	Other: Continuous Adductor Canal Block with additional Infiltration between The Popliteal Artery and Capsule; Patients will receive Continuous Adductor Canal Block with additional Infiltration between The Popliteal Artery and Capsule of The Knee

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Degree of pain	The degree of pain will be assessed using the Visual Analogue Scale (VAS). VAS score is determined by measuring the distance (mm) on the 10-cm line between the "no pain" anchor and the patient's mark, providing a range of scores from 0-100. No pain (0-4 mm), mild pain (5-44 mm), moderate pain (45-74 mm), and severe pain (75-100 mm).	24 hours postoperatively

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Total Nalbuphine consumption	Rescue analgesia will be given when VAS score ≥ 30 mm, in the form of IV injection of 10 mg Nalbuphine. Followed by reassessment of pain after 10 minutes, a second dose of Nalbuphine will be given if still VAS score ≥ 30 mm.	24 hours postoperatively
Straight leg rise	Straight leg rise (SLR) will be recorded.	24 hours postoperatively
Range of motion	Range of motion (ROM) will be recorded	24 hours postoperatively
Rate of complications	Rate of complications like falling will be recorded	24 hours postoperatively

Collaborators and Investigators

• Sponsor: Ain Shams University

Study record dates

Study Major Dates

• Study Start (Actual): January 30, 2025
• Primary Completion (Estimated): October 1, 2025
• Study Completion (Estimated): October 1, 2025

Study Registration Dates

• First Submitted: January 21, 2025
• First Submitted That Met QC Criteria: January 30, 2025
• First Posted (Actual): March 25, 2025

Study Record Updates

• Last Update Posted (Actual): March 25, 2025
• Last Update Submitted That Met QC Criteria: January 30, 2025
• Last Verified: January 1, 2025

More Information

Terms related to this study

• Other Study ID Numbers: FMASU MD134/2024

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: YES
• IPD Plan Description: The data will be available upon a reasonable request from the corresponding author after the end of study for one year.
• IPD Sharing Time Frame: After the end of study for one year.
• IPD Sharing Access Criteria: The data will be available upon a reasonable request from the corresponding author.
• IPD Sharing Supporting Information Type: STUDY_PROTOCOL

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No