The ultrasound‐guided iPACK block with continuous adductor canal block for total knee arthroplasty

Abstract

Summary We report a case of pre‐operative ultrasound‐guided local anaesthetic infiltration of the interspace between the popliteal artery and the capsule of the posterior knee (iPACK), in a 75‐year‐old male undergoing total knee arthroplasty. This was supplemented with postoperative adductor canal block using a continuous catheter technique. We assessed postoperative analgesia at rest and during active flexion of the knee, opioid consumption, motor and functional recovery, and patient satisfaction, for three postoperative days. This technique provided effective motor‐sparing analgesia, and was associated with excellent patient satisfaction.

Pain Management, Functional Recovery, and Stress Response Expressed by NLR and PLR after the iPACK Block Combined with Adductor Canal Block for Total Knee Arthroplasty—A Prospective, Randomised, Double-Blinded Clinical Trial

“…Our results suggest that an iPACK block combined with ACB can provide sufficient analgesia after orthopaedic surgery with much lower opioid consumption levels than a sham block. Other trials also have shown similar conclusions that an iPACK block with ACB can achieve better motor-sparing pain management in the immediate postoperative period compared to standard pain management protocols [9,24,25].…”