The Effect of Adductor Canal Block or Interspace between the Popliteal Artery and Posterior Capsule of Knee and Periarticular Block (Ipack Block) on Postoperative Analgesia after Knee Arthroscopy: Prospective Randomized Study

doi:10.21608/ejhm.2025.454658

The Effect of Adductor Canal Block or Interspace between the Popliteal Artery and Posterior Capsule of Knee and Periarticular Block (Ipack Block) on Postoperative Analgesia after Knee Arthroscopy: Prospective Randomized Study

Document Type : Original Article

10.21608/ejhm.2025.454658

Abstract

Background: Pain control after knee arthroscopy (KA) includes multiple modalities including systemic analgesics including narcotic and non-narcotic analgesics or regional blockades as neuraxial blockade including spinal anesthesia and epidural catheters or peripheral nerve blocks as adductor canal block (ACB) and interspace between the popliteal artery and posterior capsule of knee (IPACK) block and periarticular block and local infiltration analgesia (LIA). Objective: This work aimed to evaluate the efficacy of the ultrasound-guided IPACK versus ACB in patients planned for KA. Methods: This prospective randomized double-blind study involved 90 patients, from the ages of 21 to 65, males and females, who were scheduled for KA under spinal anesthesia. Patients were classified into two groups: Group I: IPACK block and periarticular block and Group II: ACB group.

Results: Both groups didn’t differ significantly with respect to the numerical rating score (NRS) at rest and during movement, the time taken to request rescue analgesia, or the total dose of morphine utilized. Neither the heart rate nor the mean arterial pressure varied significantly among both groups at baseline, after block, 2, 4, 8, 16, or 24 h.

There was no significant difference between the two groups with respect to patient satisfaction, hypertension, or bradycardia. Systemic toxicity from local anesthetics did not occur in both groups.

Conclusions: Anaesthetic efficacy in KA is equivalent when ACB and IPACK blocks are combined with periarticular blocks regarding pain alleviation, hemodynamic measurements, opioid intake, and patient satisfaction.

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