Comparison of the Analgesic Efficacy of Adductor Canal Block and Combined Adductor Canal Block Plus IPACK Block in Knee Surgery

Comparison of the Analgesic Efficacy of Adductor Canal Block Versus Adductor Canal Block Combined With Local Anesthetic Infiltration Between the Popliteal Artery and the Capsule of the Knee (IPACK) in Patients Undergoing Knee Surgery

To evaluate the effectiveness of Adductor Canal Block and combined Adductor Canal plus IPACK block in reducing postoperative pain and analgesic requirements in patients undergoing knee surgery.

Study Overview

• Status: Recruiting
• Conditions: Knee Arthroplasty, Total
• Intervention / Treatment: Procedure: Adductor Canal Block Group (Group I); Procedure: Adductor Canal + iPACK Block Group (Group II)"

Detailed Description

In total knee arthroplasty, ultrasound-guided Adductor canal block or Adductor Canal block combined with local anesthetic infiltration between the popliteal artery and the capsule of the knee (IPACK) will provide adequate postoperative analgesia.

• Study Type: Observational
• Enrollment (Estimated): 60

Contacts and Locations

• Study Contact: Name: Sibel Pehlivan, DR; Phone Number: 0905052532919; Email: Sibelpehlivan@erciyes.edu.tr

Study Locations

• Turkey (Türkiye)
  • Kayseri, Turkey (Türkiye), 38039
    • Recruiting
    • Sibel Seckin Pehlivan
    • Contact: Sibel Seçkin Pehlivan; Phone Number: 05052532919; Email: sibelpehlivan@erciys:edu.tr
  • Talas
    • Kayseri, Talas, Turkey (Türkiye), 38090
      • Recruiting
      • Sibel Pehlivan
      • Contact: Sibel PEHLIVAN, MD; Phone Number: 05052532919; Email: sibelpehlivan@erciys:edu.tr

Participation Criteria

Eligibility Criteria

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

• Sampling Method: Non-Probability Sample

Study Population

Patients aged ≥18 years, classified as ASA physical status I-III, scheduled to undergo total knee arthroplasty.

Description

Inclusion Criteria:

• ASA (American Society of Anesthesiologists) I- ASA II-ASA III Patients

Exclusion Criteria:

• history of allergy to the study medication
• refusal to participate

Study Plan

How is the study designed?

Number of groups / cohorts

2

Cohorts and Interventions

Group / Cohort	Intervention / Treatment
Adductor canal block group(ACB); Patients in the ACB group (Group I) will receive a single-shot adductor canal block under ultrasound guidance bupivacaine administered preoperatively.	Procedure: Adductor Canal Block Group (Group I); All patients in Group I will receive a preoperative adductor canal block. In all groups, an intravenous patient-controlled analgesia device containing morphine will be administered for postoperative pain management.
Adductor canal + iPACK block group(ACB+IPACK); Patients in the ACB + iPACK group (Group II) will receive a single-shot adductor canal block combined with an infiltration between the popliteal artery and the capsule of the knee (iPACK) under ultrasound guidance bupivacaine.	Procedure: Adductor Canal + iPACK Block Group (Group II)"; All patients in Group II will receive a preoperative adductor canal block combined with an iPACK block. Postoperatively, all patients in both groups will be provided with intravenous patient-controlled analgesia containing morphine for pain management.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Verbal analog Pain Scores on rest and movement	A Research assistant, blinded to the group allocation, interviewed patients and collected data at 5 times intervals ( 2, 4, 6, 12, 24, hours) in the 24 hours postoperatively. Patients were asked to rate their pain using verbal analog scale, where 0= no pain and 10= worst pain possible.	24 hours after surgery
opioid consumption	In the recovery room, all patients will given a patient- controlled analgesia device containing morphine 0.5 mg/ml, set to deliver a 1mg bolus dose of morphine with an 15 min lockout time and 4 mg 1 h limit.Total morphine consumption during the 24 hours postoperative period will recorded at 5 times intervals ( 2, 4, 6, 12, 24 hours).	24 hours after surgery

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
incidences of adverse effects (like nausea and vomiting)	incidences of nausea and vomiting during the 24 hours postoperative period will recorded at 6 time intervals ( 2, 4, 6, 12, 24 hours).	24 hours after surgery

Collaborators and Investigators

• Sponsor: TC Erciyes University
• Investigators: Study Director: Sibel Pehlivan, Erciyes Üniversitesi

Publications and helpful links

General Publications

• Shoni M, Samineni AV, Salavati S, Mikkilineni N, Wang A, Abdeen A, Freccero D. Combined Single-Shot Infiltration Between the Popliteal Artery and Capsule of the Knee and Adductor Canal Block With Bupivacaine, Dexmedetomidine, and Dexamethasone for Total Knee Arthroplasty: A Propensity-Matched Analysis. Arthroplast Today. 2023 Dec 28;25:101292. doi: 10.1016/j.artd.2023.101292. eCollection 2024 Feb.
• Mariano ER, Kim TE, Wagner MJ, Funck N, Harrison TK, Walters T, Giori N, Woolson S, Ganaway T, Howard SK. A randomized comparison of proximal and distal ultrasound-guided adductor canal catheter insertion sites for knee arthroplasty. J Ultrasound Med. 2014 Sep;33(9):1653-62. doi: 10.7863/ultra.33.9.1653.

Helpful Links

• Combined Single-Shot Infiltration Between the Popliteal Artery and Capsule of the Knee and Adductor Canal Block With Bupivacaine, Dexmedetomidine, and Dexamethasone for Total Knee Arthroplasty: A Propensity-Matched Analysis

Study record dates

Study Major Dates

• Study Start (Estimated): April 15, 2026
• Primary Completion (Estimated): April 15, 2028
• Study Completion (Estimated): May 1, 2028

Study Registration Dates

• First Submitted: April 7, 2026
• First Submitted That Met QC Criteria: April 7, 2026
• First Posted (Actual): April 13, 2026

Study Record Updates

• Last Update Posted (Actual): May 14, 2026
• Last Update Submitted That Met QC Criteria: May 13, 2026
• Last Verified: May 1, 2026

More Information

Terms related to this study

• Keywords: ultrasound; Adductor Canal Block; IPACK block
• Other Study ID Numbers: 2026\115

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: YES
• IPD Plan Description: De-identified individual participant data for all primary and secondary outcome measures will be made available.
• IPD Sharing Time Frame: Data will be available within 12 months of study completion
• IPD Sharing Access Criteria: Data accept requests will be reviewed by an external independent Review Panel.Requesters will be required to sign a Data Access Agreement.
• IPD Sharing Supporting Information Type: STUDY_PROTOCOL; SAP; ICF; ANALYTIC_CODE; CSR

Drug and device information, study documents

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