A Comparative Study between Adductor Canal Block and IPACK Block (Interspace between Popliteal Artery and the Capsule of Posterior Knee) vs ACB Alone vs IPACK Alone after Total Knee Arthroplasty for Post Operative Pain and Mobility

Background: Adductor canal block is a peripheral nerve blockade technique that provides good pain control for patients undergoing unilateral total knee arthroplasty which however does not relieve and spare posterior knee pain. The recent technique of an ultrasound-guided local anesthetic infiltration of the interspace between popliteal artery and the capsule of posterior knee has shown promising results in providing significant analgesia for posterior knee pain without affecting the motor nerves. The aim of the study is to evaluate the effect of ACB plus IPACK vs ACB only VS IPACK only in patients post unilateral knee arthroplasty for post operative pain and mobility.Results:There results showed significant difference between groups at amount of opioids used. Opioid consumption was lower in group C compared to group A and group B. There was statistically significant difference between groups regarding time to mobility being significantly lower in Group C in comparison to both groups A and BConclusions : The ACB + IPACK is a promising technique that offers improved pain management in the immediate postoperative period without affecting the motor function around the knee joint resulting in better ROM and ambulation compared to ACB alone and IPACK alone.