Continuous Adductor Canal Block (ACB) Versus ACB with Peri-Articular Injection and ACB with IPACK for Postoperative Analgesia in Total Knee Arthroplasty

Rabab Mohamed Mohamed; Jehan Mohammad Darwish Hamed

doi:doi:10.11648/j.ijacm.20221002.13

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Continuous Adductor Canal Block (ACB) Versus ACB with Peri-Articular Injection and ACB with IPACK for Postoperative Analgesia in Total Knee Arthroplasty

Rabab Mohamed Mohamed, Jehan Mohammad Darwish Hamed

Published in International Journal of Anesthesia and Clinical Medicine (Volume 10, Issue 2)

Received: 5 November 2022 Accepted: 7 December 2022 Published: 27 December 2022

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Abstract

Background: Acute postoperative pain after total knee arthroplasty (TKA) is so severe that patients are entitled to analgesia that avoids the detrimental effects of pain on several body systems. Objectives: This study compared the post-operative analgesic impact of continuous adductor canal block to that of adductor canal block with peri-articular injection (PAI) and adductor canal block (ACB) with infiltration of the interspace between the popliteal artery and the capsule of the posterior knee (IPACK) in TKA. Patients and Methods: This prospective randomized trial included 60 adult cases with severe knee osteoarthritis scheduled for elective TKA. Patients were randomly divided into three equal groups: group I received ACB and a continuous adductor canal block (CACB), group II received ACB and PAI, group III received ACB and IPACK. Results: Significant increase in NRS values was detected in CACB patients at 2h post operative (p=0.001) while a significant decrease in NRS in PAI group patients at 6h and 12 h post operative (All P values < 0.05) respectively. Motion ability was recorded through the use of Time Up and Go test (TUG) showed the shortest records in PAI block group than CACB and IPACK groups, p=0.001 at 12h post operative. At 24 h post operative, the IPACK group showed the shortest time records than PAI and CACB patients (p value < 0.05). Conclusion: In TKA, PAI has higher quadriceps muscle power and lower TUG and length hospital stay compared to ACB with IPACK and continuous ACB. ACB with PAI and ACB with IPACK are associated with better analgesia (prolonged action and lower morphine consumption) compared to continuous ACB.

Published in	International Journal of Anesthesia and Clinical Medicine (Volume 10, Issue 2)
DOI	10.11648/j.ijacm.20221002.13
Page(s)	57-64
Creative Commons	This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.
Copyright	Copyright © The Author(s), 2022. Published by Science Publishing Group

Keywords

Analgesia, Adductor Canal Block, Peri-Articular, Infiltration, IPACK, Total Knee Arthroplasty

References

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APA Style

Rabab Mohamed Mohamed, Jehan Mohammad Darwish Hamed. (2022). Continuous Adductor Canal Block (ACB) Versus ACB with Peri-Articular Injection and ACB with IPACK for Postoperative Analgesia in Total Knee Arthroplasty. International Journal of Anesthesia and Clinical Medicine, 10(2), 57-64. https://doi.org/10.11648/j.ijacm.20221002.13

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ACS Style

Rabab Mohamed Mohamed; Jehan Mohammad Darwish Hamed. Continuous Adductor Canal Block (ACB) Versus ACB with Peri-Articular Injection and ACB with IPACK for Postoperative Analgesia in Total Knee Arthroplasty. Int. J. Anesth. Clin. Med. 2022, 10(2), 57-64. doi: 10.11648/j.ijacm.20221002.13

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AMA Style

Rabab Mohamed Mohamed, Jehan Mohammad Darwish Hamed. Continuous Adductor Canal Block (ACB) Versus ACB with Peri-Articular Injection and ACB with IPACK for Postoperative Analgesia in Total Knee Arthroplasty. Int J Anesth Clin Med. 2022;10(2):57-64. doi: 10.11648/j.ijacm.20221002.13

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@article{10.11648/j.ijacm.20221002.13,
  author = {Rabab Mohamed Mohamed and Jehan Mohammad Darwish Hamed},
  title = {Continuous Adductor Canal Block (ACB) Versus ACB with Peri-Articular Injection and ACB with IPACK for Postoperative Analgesia in Total Knee Arthroplasty},
  journal = {International Journal of Anesthesia and Clinical Medicine},
  volume = {10},
  number = {2},
  pages = {57-64},
  doi = {10.11648/j.ijacm.20221002.13},
  url = {https://doi.org/10.11648/j.ijacm.20221002.13},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ijacm.20221002.13},
  abstract = {Background: Acute postoperative pain after total knee arthroplasty (TKA) is so severe that patients are entitled to analgesia that avoids the detrimental effects of pain on several body systems. Objectives: This study compared the post-operative analgesic impact of continuous adductor canal block to that of adductor canal block with peri-articular injection (PAI) and adductor canal block (ACB) with infiltration of the interspace between the popliteal artery and the capsule of the posterior knee (IPACK) in TKA. Patients and Methods: This prospective randomized trial included 60 adult cases with severe knee osteoarthritis scheduled for elective TKA. Patients were randomly divided into three equal groups: group I received ACB and a continuous adductor canal block (CACB), group II received ACB and PAI, group III received ACB and IPACK. Results: Significant increase in NRS values was detected in CACB patients at 2h post operative (p=0.001) while a significant decrease in NRS in PAI group patients at 6h and 12 h post operative (All P values Conclusion: In TKA, PAI has higher quadriceps muscle power and lower TUG and length hospital stay compared to ACB with IPACK and continuous ACB. ACB with PAI and ACB with IPACK are associated with better analgesia (prolonged action and lower morphine consumption) compared to continuous ACB.},
 year = {2022}
}

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TY  - JOUR
T1  - Continuous Adductor Canal Block (ACB) Versus ACB with Peri-Articular Injection and ACB with IPACK for Postoperative Analgesia in Total Knee Arthroplasty
AU  - Rabab Mohamed Mohamed
AU  - Jehan Mohammad Darwish Hamed
Y1  - 2022/12/27
PY  - 2022
N1  - https://doi.org/10.11648/j.ijacm.20221002.13
DO  - 10.11648/j.ijacm.20221002.13
T2  - International Journal of Anesthesia and Clinical Medicine
JF  - International Journal of Anesthesia and Clinical Medicine
JO  - International Journal of Anesthesia and Clinical Medicine
SP  - 57
EP  - 64
PB  - Science Publishing Group
SN  - 2997-2698
UR  - https://doi.org/10.11648/j.ijacm.20221002.13
AB  - Background: Acute postoperative pain after total knee arthroplasty (TKA) is so severe that patients are entitled to analgesia that avoids the detrimental effects of pain on several body systems. Objectives: This study compared the post-operative analgesic impact of continuous adductor canal block to that of adductor canal block with peri-articular injection (PAI) and adductor canal block (ACB) with infiltration of the interspace between the popliteal artery and the capsule of the posterior knee (IPACK) in TKA. Patients and Methods: This prospective randomized trial included 60 adult cases with severe knee osteoarthritis scheduled for elective TKA. Patients were randomly divided into three equal groups: group I received ACB and a continuous adductor canal block (CACB), group II received ACB and PAI, group III received ACB and IPACK. Results: Significant increase in NRS values was detected in CACB patients at 2h post operative (p=0.001) while a significant decrease in NRS in PAI group patients at 6h and 12 h post operative (All P values Conclusion: In TKA, PAI has higher quadriceps muscle power and lower TUG and length hospital stay compared to ACB with IPACK and continuous ACB. ACB with PAI and ACB with IPACK are associated with better analgesia (prolonged action and lower morphine consumption) compared to continuous ACB.
VL  - 10
IS  - 2
ER  -

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Author Information

Rabab Mohamed Mohamed

Anesthesiology, Surgical Intensive Care and Pain Medicine Department, Faculty of Medicine, Tanta University, Tanta, Egypt
Jehan Mohammad Darwish Hamed

Anesthesiology, Surgical Intensive Care and Pain Medicine Department, Faculty of Medicine, Tanta University, Tanta, Egypt

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APA Style

Rabab Mohamed Mohamed, Jehan Mohammad Darwish Hamed. (2022). Continuous Adductor Canal Block (ACB) Versus ACB with Peri-Articular Injection and ACB with IPACK for Postoperative Analgesia in Total Knee Arthroplasty. International Journal of Anesthesia and Clinical Medicine, 10(2), 57-64. https://doi.org/10.11648/j.ijacm.20221002.13

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ACS Style

Rabab Mohamed Mohamed; Jehan Mohammad Darwish Hamed. Continuous Adductor Canal Block (ACB) Versus ACB with Peri-Articular Injection and ACB with IPACK for Postoperative Analgesia in Total Knee Arthroplasty. Int. J. Anesth. Clin. Med. 2022, 10(2), 57-64. doi: 10.11648/j.ijacm.20221002.13

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AMA Style

Rabab Mohamed Mohamed, Jehan Mohammad Darwish Hamed. Continuous Adductor Canal Block (ACB) Versus ACB with Peri-Articular Injection and ACB with IPACK for Postoperative Analgesia in Total Knee Arthroplasty. Int J Anesth Clin Med. 2022;10(2):57-64. doi: 10.11648/j.ijacm.20221002.13

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@article{10.11648/j.ijacm.20221002.13,
  author = {Rabab Mohamed Mohamed and Jehan Mohammad Darwish Hamed},
  title = {Continuous Adductor Canal Block (ACB) Versus ACB with Peri-Articular Injection and ACB with IPACK for Postoperative Analgesia in Total Knee Arthroplasty},
  journal = {International Journal of Anesthesia and Clinical Medicine},
  volume = {10},
  number = {2},
  pages = {57-64},
  doi = {10.11648/j.ijacm.20221002.13},
  url = {https://doi.org/10.11648/j.ijacm.20221002.13},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ijacm.20221002.13},
  abstract = {Background: Acute postoperative pain after total knee arthroplasty (TKA) is so severe that patients are entitled to analgesia that avoids the detrimental effects of pain on several body systems. Objectives: This study compared the post-operative analgesic impact of continuous adductor canal block to that of adductor canal block with peri-articular injection (PAI) and adductor canal block (ACB) with infiltration of the interspace between the popliteal artery and the capsule of the posterior knee (IPACK) in TKA. Patients and Methods: This prospective randomized trial included 60 adult cases with severe knee osteoarthritis scheduled for elective TKA. Patients were randomly divided into three equal groups: group I received ACB and a continuous adductor canal block (CACB), group II received ACB and PAI, group III received ACB and IPACK. Results: Significant increase in NRS values was detected in CACB patients at 2h post operative (p=0.001) while a significant decrease in NRS in PAI group patients at 6h and 12 h post operative (All P values Conclusion: In TKA, PAI has higher quadriceps muscle power and lower TUG and length hospital stay compared to ACB with IPACK and continuous ACB. ACB with PAI and ACB with IPACK are associated with better analgesia (prolonged action and lower morphine consumption) compared to continuous ACB.},
 year = {2022}
}

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TY  - JOUR
T1  - Continuous Adductor Canal Block (ACB) Versus ACB with Peri-Articular Injection and ACB with IPACK for Postoperative Analgesia in Total Knee Arthroplasty
AU  - Rabab Mohamed Mohamed
AU  - Jehan Mohammad Darwish Hamed
Y1  - 2022/12/27
PY  - 2022
N1  - https://doi.org/10.11648/j.ijacm.20221002.13
DO  - 10.11648/j.ijacm.20221002.13
T2  - International Journal of Anesthesia and Clinical Medicine
JF  - International Journal of Anesthesia and Clinical Medicine
JO  - International Journal of Anesthesia and Clinical Medicine
SP  - 57
EP  - 64
PB  - Science Publishing Group
SN  - 2997-2698
UR  - https://doi.org/10.11648/j.ijacm.20221002.13
AB  - Background: Acute postoperative pain after total knee arthroplasty (TKA) is so severe that patients are entitled to analgesia that avoids the detrimental effects of pain on several body systems. Objectives: This study compared the post-operative analgesic impact of continuous adductor canal block to that of adductor canal block with peri-articular injection (PAI) and adductor canal block (ACB) with infiltration of the interspace between the popliteal artery and the capsule of the posterior knee (IPACK) in TKA. Patients and Methods: This prospective randomized trial included 60 adult cases with severe knee osteoarthritis scheduled for elective TKA. Patients were randomly divided into three equal groups: group I received ACB and a continuous adductor canal block (CACB), group II received ACB and PAI, group III received ACB and IPACK. Results: Significant increase in NRS values was detected in CACB patients at 2h post operative (p=0.001) while a significant decrease in NRS in PAI group patients at 6h and 12 h post operative (All P values Conclusion: In TKA, PAI has higher quadriceps muscle power and lower TUG and length hospital stay compared to ACB with IPACK and continuous ACB. ACB with PAI and ACB with IPACK are associated with better analgesia (prolonged action and lower morphine consumption) compared to continuous ACB.
VL  - 10
IS  - 2
ER  -

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