การศึกษาเปรียบเทียบประสิทธิภาพในการลดอาการปวดของการฉีดยาชาบริเวณ เนื้อเยื่อหลังข้อเข่าร่วมกับการฉีดยาชาบริเวณต้นขาส่วนในกับการฉีดการฉีดยาชา บริเวณต้นขาส่วนในในการผ่าตัดข้อเข่าเทียม

yuwarin kositworakitkun; Anchalee Chaweesak; Petchrat Taecholarn

doi:10.1016/hscr.v39i1.267294

Authors

yuwarin kositworakitkun Anesthesiology uttaradit hospital
Anchalee Chaweesak Anesthesiology uttaradit hospital
Petchrat Taecholarn Anesthesiology uttaradit hospital

DOI:

https://doi.org/10.1016/hscr.v39i1.267294

Keywords:

Total knee arthroplasty (TKA), Adductor canal block, IPACK block (Interspace between the popliteal artery and the capsule of the posterior knee)

Abstract

ABSTRACT
Objective: To compare the analgesic efficacy of IPACK block plus Adductor canal block with Adductor canal block after total knee arthroplasty.
Methods: After ethical approval from Uttaradit Hospital, A total 22 patients undergoing knee replacement surgery with spinal anesthesia were randomized into 2 groups, ADB (n=11) and Group2 IPACK block (n=11). Group ADB receives Adductor canal block for analgesic control after Total knee arthroplasty and Group IPACK block receives IPACK block with Adductor canal block. The study analgesic efficacy was recorded by pain score (NRS = Numerical rating scale) and morphine consumption 24 hr after surgery. The study found out the physical therapy and complications from intervention and pain medications after Total knee arthroplasty. Data were analyzed using a p-value <0.05 considered to be statistically significant.
Results: Pain score in group IPACK block was lower than ADB group 24 hr after TKA with statistically significant (3.82 compared to 5.09, p=0.03). The morphine consumption was lower in IPACK group 24 hr after surgery (10.64 mg compared to 14.55 mg, p=0.027) but there is no statistical significance. Patients in both groups can do the physical therapy on Day 1 after surgery and the complications after
surgery are not statistically significant.
Conclusions: A combination of IPACK block and adductor canal block can lower pain score than Adductor canal block after total knee arthroplasty under spinal anesthesia and there are no severe complications in both groups.
Keywords: Total knee arthroplasty (TKA), Adductor canal block, IPACK block (Interspace between the popliteal artery and the capsule of the posterior knee)

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