IPACK and adductor canal block in knee arthroplasty
Abstract
Knee arthroplasty is a surgical procedure that involves acute pain of moderate intensity in the postoperative period, for which techniques are needed to provide adequate analgesia in this group of patients. This work highlights the IPACK and the adductor canal block, whose purpose is to perform a blockade of the nerves that innervate the knee in a safe way for the patient. A descriptive literature review was carried out, using meta-search engines such as Epistemonikos, where information from high impact journals and randomized clinical studies was included. The results of this literature review showed that the use of IPACK and adductor canal block in knee arthroplasty, minimizes postoperative pain, being an effective and updated anesthesia to be used in these patients. In conclusion, the use of this type of analgesic block is a safe and effective technique in patients undergoing this type of procedure, for the control of acute postoperative pain and to avoid its chronification.
Keywords: arthroplasty, IPACK block, adductor canal block
Downloads
References
Díaz Martínez JV, Pérez Navarro GI, Sánchez Alepuz E, Miranda I, Peregrín Nevado I, Collado Sánchez A. Bloqueo IPACK asociado a bloqueo del canal de los aductores frente a bloqueo femoral, calidad analgésica y uso de rescate tras artroplastia total de rodilla. Rev. española de cirugía osteoarticular. 2018;53(275):95-101.
Sikachi RR, Campbell B, Kassin E, Scuderi GR, Marino J. Analgesic Trends in the Management of Pain Following Total Knee Arthroplasty: A Comparison of Peri-Articular Infiltration, Adductor Canal Block, and Adjuvant Treatment for Posterior Knee Pain. Orthopedic Clinics of North America. 2023;54(4):369-76.
de Ladoucette A. Management of perioperative pain after TKA. Orthopaedics & Traumatology: Surgery & Research. 2023;109(1, Supplement):103443.
Domagalska M, Wieczorowska-Tobis K, Reysner T, Kowalski G. Periarticular injection, IPACK block, and peripheral nerve block in pain management after total knee arthroplasty: a structured narrative review. Perioper Med (Lond). 2023; 12:59.
Tran J, Giron Arango L, Peng P, Sinha SK, Agur A, Chan V. Evaluation of the IPACK block injectate spread: a cadaveric study. Reg Anesth Pain Med. 2019;rapm-2018-100355.
Sáenz Gaitán PC. Efectividad analgésica postoperatoria del bloqueo del canal de los aductores con y sin bloqueo IPACK en reemplazo total de rodilla. [Tesis]Ecuador Universidad Autónoma de Bucaramanga; 2019 Disponible en:
Summers S, Mohile N, McNamara C, Osman B, Gebhard R, Hernandez VH. Analgesia in Total Knee Arthroplasty: Current Pain Control Modalities and Outcomes. JBJS. 2020;102(8):719.
Kandarian B, Indelli PF, Sinha S, Hunter OO, Wang RR, Kim TE, et al. Implementation of the IPACK (Infiltration between the Popliteal Artery and Capsule of the Knee) block into a multimodal analgesic pathway for total knee replacement. Korean J Anesthesiol. 2019;72(3):238-44.
Sveom DS, Horberg JV, Allen DA, Mann JW, Moskal JT. Ultrasound-Guided Adductor Canal Block Versus Intraoperative Transarticular Saphenous Nerve Block: A Retrospective Analysis. The Journal of Arthroplasty. 2022;37(6, Supplement):S134-8.
Wang F, Ma W, Huang Z. Analgesia effects of IPACK block added to multimodal analgesia regiments after total knee replacement. Medicine (Baltimore). 2021;100(22):e25884.
Zamudio-Castilla LM, González Vera JF, Rodríguez-Conde JR, Dorado-Velasco FC, Zamudio-Castilla LM, González Vera JF, et al. Implementación y evaluación de un protocolo de analgesia multimodal en el reemplazo total primario de rodilla que incluye bloqueo de canal de aductores guiado por ultrasonografía más infiltración de anestésico local periarticular. Rev. de la Sociedad Española del Dolor. 2021;28(1):9-18.
ÁMA D, JAC S, Gómez SR, R MV, Zárate E. Actualidad en el manejo de dolor post operatorio de artroplastia de rodilla mediante técnica de bloqueo canal de los aductores. Rev. Médica Sanitas. 2018;21(2):69-75.
Sercia QP, Bergeron JJ, Pelet S, Belzile ÉL. Continuous vs. single-shot adductor canal block for pain management following primary total knee arthroplasty: A systematic review and meta-analysis of randomized controlled trials. Orthopaedics & Traumatology: Surgery & Research. 2022;108(8):103290.
Chan E, Howle R, Onwochei D, Desai N. Infiltration between the popliteal artery and the capsule of the knee (IPACK) block in knee surgery: a narrative review. Reg Anesth Pain Med. 2021;46(9):784-805.
Batko BD, Ippolito JA, Gupta A, Bukowiec L, Potter JS, Joshi T, et al. Synergistic effects of robotic surgery and IPACK nerve block on reduction of opioid consumption in total knee arthroplasty. Journal of Orthopaedics. 2022;34:226-32.
D’Souza RS, Langford BJ, Olsen DA, Johnson RL. Ultrasound-Guided Local Anesthetic Infiltration Between the Popliteal Artery and the Capsule of the Posterior Knee (IPACK) Block for Primary Total Knee Arthroplasty: A Systematic Review of Randomized Controlled Trials. Local Reg Anesth. 2021;14:85-98.
Hernández JAG, Maloni FC. Bloqueo capsular versus bloqueo IPACK: Comparación en el manejo del dolor en pacientes con reemplazo total de rodilla. Rev. Científica CMDLT. 2021;15(1).
Caballero-Lozada AF, Gómez JM, Ramírez JA, Posso M, Zorrilla-Vaca A, Lasso LF, et al. IPACK block: emerging complementary analgesic technique for total knee arthroplasty. Colombian Journal of Anestesiology. 2020;48(2):78-84.
Deiter J, Ponzio D, Grau L, Griffiths S, Ong A, Post Z, et al. Efficacy of adductor canal block protocol implementation in a multimodal pain management protocol for total knee arthroplasty. J Clin Orthop Trauma. 2020;11(1):118-21.
Guo J, Hou M, Shi G, Bai N, Huo M.IPACK block (local anesthetic infiltration of the interspace between the popliteal artery and the posterior knee capsule) added to the adductor canal blocks versus the adductor canal blocks in the pain management after total knee arthroplasty: a systematic review and meta-analysis. J Orthop Surg Res. 2022;17:387.
Mou P, Wang D, Tang XM, Zeng WN, Zeng Y, Yang J, et al. Adductor Canal Block Combined With IPACK Block for Postoperative Analgesia and Function Recovery Following Total Knee Arthroplasty: A Prospective, Double-Blind, Randomized Controlled Study. The Journal of Arthroplasty. 2022;37(2):259-66.
Zheng FY, Liu YB, Huang H, Xu S, Ma XJ, Liu YZ, et al. The impact of IPACK combined with adductor canal block under ultrasound guidance on early motor function after total knee arthroplasty. Brazilian Journal of Anesthesiology. 2022;72(1):110-4.
Published
How to Cite
Issue
Section
License
ACCESS AND DISTRIBUTION POLICY
All published articles are open access contributions, which are distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License which permits unrestricted non-commercial use, distribution and reproduction in any medium, provided that the primary source of publication is properly cited.