Adductor Canal Block With IPCAK Versus 4-in-1 Block for Postoperative Analgesia in Knee Surgery

July 13, 2026 updated by: Zagazig University

Effect of Adductor Canal Block With Infiltration of the Posterior Capsule of the Knee Versus 4-in-1 Block Technique for Postoperative Analgesia in Patients Undergoing Knee Surgeries

This randomized interventional study compares the analgesic efficacy of Adductor Canal Block combined with Infiltration of the Posterior Capsule of the Knee (IPCAK) versus the 4-in-1 block technique in patients undergoing knee surgery. Twenty-four patients were randomly allocated into two equal groups. The primary objective is to compare postoperative pain scores and analgesic requirements. Secondary outcomes include time to first rescue analgesia, total analgesic consumption, motor function preservation, and block-related complications.

Study Overview

Status

Completed

Conditions

Intervention / Treatment

Detailed Description

Effective postoperative pain control following knee surgery is essential for early mobilization, rehabilitation, and patient satisfaction. Several regional anesthesia techniques have been developed to provide analgesia while preserving quadriceps muscle strength. Adductor Canal Block combined with Infiltration of the Posterior Capsule of the Knee (IPCAK) has been proposed as a motor-sparing technique that provides effective anterior and posterior knee analgesia. The 4-in-1 block is another ultrasound-guided regional anesthesia technique designed to provide comprehensive analgesia for knee surgery.

This prospective randomized interventional study enrolled 24 patients undergoing knee surgery. Participants were randomly assigned to receive either Adductor Canal Block with IPCAK or the 4-in-1 block. Postoperative pain scores, time to first rescue analgesia, total analgesic consumption, motor function, patient satisfaction, and complications were evaluated and compared between the two groups

Study Type

Interventional

Enrollment (Actual)

24

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 Locations

  • Egypt
    • Sharqia Province
      • Zagazig, Sharqia Province, Egypt, 055
        • Faculty of Medicine, Zagazig University Hospitals

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

  • Adult

Accepts Healthy Volunteers

Yes

Description

Inclusion Criteria:

  • 1. Patients or caregivers acceptance. 2. Age : 21 - 64 years 3. Sex : both ( males & females). 4. Physical status: ASA І & II. 5. BMI 18.5-30 kg/m2. 6. Type of operations : elective surgery. 7. Type of anesthesia: unilateral intrathecal anesthesia. 8. Patients undergoing elective knee surgery under unilateral spinal anesthesia 9. Duration of surgery within 2 hr.

Exclusion Criteria:

  • Known history of allergy to study drug Coagulopathies or taking drugs affecting coagulation.. Contraindications for peripheral nerve block (PNB) and spinal anesthesia (SA) (coagulation defects, infection at the puncture site), bone degenerative disease and posttraumatic condition of the spine, dementia and severe visual or auditory disorder.

Current severe psychiatric disease, alcoholism or drug dependence. Subjects with history previous knee surgery, osteoarthritis, malformation or tumors (including Baker's cyst), which could alter the normal anatomy of the popliteal fossa

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: Treatment
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: None (Open Label)

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: Adductor canal block+ IPACK
Patients receive ultrasound-guided Adductor Canal Block combined with Infiltration of the Posterior Capsule of the Knee (IPCAK) for postoperative analgesia after knee surgery
Procedure: Adductor canal block with IPACK
Ultrasound-guided Adductor Canal Block combined with IPCAK block
Experimental: 4 in 1 block
Patients receive ultrasound-guided 4-in-1 block for postoperative analgesia after knee surgery.
Procedure: 4 in 1 block
Ultrasound-guided 4-in-1 block technique.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Postoperative pain intensity measured by Visual Analog Scale (VAS)
Time Frame: 24 hours after surgery
Postoperative pain will be assessed using the Visual Analog Scale (VAS) at rest and during movement at predetermined postoperative time points
24 hours after surgery

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Total opioid consumption
Time Frame: First 24 hours after surgery
Total rescue opioid analgesic consumption during the first 24 postoperative hours
First 24 hours after surgery
Time to first rescue analgesia
Time Frame: Within 24 hours after surgery
Time from completion of surgery to the first request for rescue analgesia
Within 24 hours after surgery
Patient satisfaction with postoperative analgesia
Time Frame: 24 hours after surgery
Patient satisfaction score regarding postoperative pain management
24 hours after surgery

Collaborators and Investigators

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

Sponsor

Zagazig University

Investigators

  • Study Chair: Abdalla Mohamed Goda, MD, Faculty of Medicine, Zagazig University
  • Study Director: Yasser Mohamed Naser, MD, Faculty of Medicine, Zagazig 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 (Actual)

June 22, 2026

Primary Completion (Actual)

June 22, 2026

Study Completion (Actual)

June 22, 2026

Study Registration Dates

First Submitted

July 8, 2026

First Submitted That Met QC Criteria

July 13, 2026

First Posted (Actual)

July 14, 2026

Study Record Updates

Last Update Posted (Actual)

July 14, 2026

Last Update Submitted That Met QC Criteria

July 13, 2026

Last Verified

July 1, 2026

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • 1763

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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