Comparison Between Two Blocks in Analgesia After Knee Arthroplasty

Comparative Study Between Adductor Canal Block Combined With (IPACK) Block Versus Genicular Nerves Block Combined With (IPACK) Block Regarding Postoperative Analgesic Effect After Knee Replacement Surgery.

Comparative Study between Adductor canal block combined with infiltration OF The interspace between popliteal artery and the capsule of the knee block versus genicular nerves Block combined with IPACK in Postoperative analgesia after knee replacement surgery

Study Overview

• Status: Active, not recruiting
• Conditions: Post Operative Pain
• Intervention / Treatment: Procedure: ACB - IPACK; Procedure: GNB - IPACK

Detailed Description

Patient informed written consent and ethical committee approval of Faculty of Medicine; Ain Shams University will be obtained before patient allocation.

• Study procedures: Supervisors and experts will do all the study procedures.

Patients undergoing unilateral Total knee replacement (TKR) will be randomly assigned into one of the following groups using computer generated codes (15 patients in each group):

Group 1 (ACB - IPACK group): will receive spinal anesthesia and ultrasound-guided Adductor canal nerve block, as well as infiltration of the space between the popliteal artery and the capsule of the posterior knee (IPACK) block.

Group 2 (GNB - IPACK group): will recieve spinal anesthesia and US guided Genicular nerves block and IPACK block.

• Study Type: Interventional
• Enrollment (Actual): 30
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Egypt
  • Cairo, Egypt
    • Ain Shams University

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: Yes

Description

Inclusion Criteria:

• Age 30-85 years.
• Both sexes.
• American Society of Anesthesiologists (ASA) Physical Status Class I to III.
• Patients scheduled for unilateral TKA under spinal anesthesia.

Exclusion Criteria:

• Patient's refusal.
• American Society of Anesthesiologists (ASA) Physical Status Class above III.
• local infection.
• History of allergy to the medications used in the study. 5. Psychiatric disorder.

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Other
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: Single

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Active Comparator: Group 1; Adductor canal block + IPACK group	Procedure: ACB - IPACK; will receive spinal anesthesia and ultrasound-guided Adductor canal nerve block, as well as infiltration of the space between the popliteal artery and the capsule of the posterior knee (IPACK) block.
Active Comparator: Group 2; Genicular nerves block + IPACK block.	Procedure: GNB - IPACK; will recieve spinal anesthesia and US guided Genicular nerves block and IPACK block.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
1- Comparing both groups regarding the time needed ( in hours) for the first call rescue analgesia post operatively.	Total knee replacement (TKR) is a well-known popular surgical procedure for knee diseases, including end-stage knee osteoarthritis that causes severe postoperative pain and prolonged immobility. Acute pain control can be provided with multimodal analgesia, including non-steroidal anti-inflammatory drugs (NSAIDs) and opioids. However, NSAIDs cause many side effects as peptic ulcer and gastritis, also opioids have gastrointestinal side effects as constipation, nausea and vomiting as well as respiratory depression. Regional analgesia has been used as another modality to provide sufficient perioperative pain relief with minimal opioid consumption to avoid it's adverse effects peripheral nerve blocks (PNBs) is a common practice in orthopedic surgery. PNBs provide excellent pain management after TKA, promote early mobilization, and reduce the consumption of opioids, the incidence of opioid-related adverse effects, and the hospital stay	5 minutes after ending of operation

Collaborators and Investigators

• Sponsor: Ain Shams University
• Investigators: Principal Investigator: Mai Ma Abd ElAziz, MBBCH, Ain Shams University; Principal Investigator: Mai Ma Abd ElAziz Ibrahim, MBBCH, Ain Shams University

Study record dates

Study Major Dates

• Study Start (Actual): January 29, 2025
• Primary Completion (Estimated): July 29, 2025
• Study Completion (Estimated): July 29, 2025

Study Registration Dates

• First Submitted: May 6, 2025
• First Submitted That Met QC Criteria: June 29, 2025
• First Posted (Estimated): July 1, 2025

Study Record Updates

• Last Update Posted (Estimated): July 1, 2025
• Last Update Submitted That Met QC Criteria: June 29, 2025
• Last Verified: May 1, 2025

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Pain; Neurologic Manifestations; Postoperative Complications; Pathologic Processes; Pain, Postoperative
• Other Study ID Numbers: FMASU MS64/2025

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: YES
• IPD Plan Description: All data will be shared once Study is completed
• IPD Sharing Time Frame: Before 1/2026
• IPD Sharing Access Criteria: Free
• IPD Sharing Supporting Information Type: STUDY_PROTOCOL; SAP; ICF

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No
• product manufactured in and exported from the U.S.: No