Actively Recruiting
ACB With S-ESPB Versus ACB With iPACK for Knee Arthroplasty
Led by Poznan University of Medical Sciences · Updated on 2026-02-02
80
Participants Needed
1
Research Sites
57 weeks
Total Duration
On this page
AI-Summary
What this Trial Is About
This study will compare two regional anesthesia strategies for pain management after total knee arthroplasty in adults. Both strategies use an adductor canal block (ACB) to provide analgesia while preserving quadriceps muscle strength. The ACB is then combined with either a sacral erector spinae plane block (S-ESPB) or an iPACK (infiltration between the popliteal artery and the posterior capsule of the knee) block to improve posterior knee analgesia. All patients will receive an ultrasound-guided adductor canal block with 20 mL of 0.2% ropivacaine. They will then be randomly assigned to one of two groups: Group 1: ACB combined with a sacral erector spinae plane block (S-ESPB) using 20 mL of 0.2% ropivacaine. Group 2: ACB combined with an iPACK block using 20 mL of 0.2% ropivacaine. Both techniques aim to provide effective postoperative analgesia while minimizing motor blockade and allowing for early mobilization. It is not known whether combining ACB with S-ESPB or with iPACK provides superior pain control, reduces opioid requirements, or results in better functional recovery after total knee arthroplasty. The main purpose of this study is to compare the time to first rescue analgesia and overall postoperative pain control between the two regional anesthesia strategies. The study will also evaluate opioid consumption, motor function, functional mobility, side effects, and block-related complications. We hypothesize that both combinations will provide effective analgesia, but their impact on pain intensity, duration of analgesia, and functional recovery may differ.
CONDITIONS
Official Title
ACB With S-ESPB Versus ACB With iPACK for Knee Arthroplasty
Who Can Participate
Eligibility Criteria
You may qualify if you...
- Age 65 years or older
- Scheduled for elective unilateral total knee arthroplasty under spinal or general anesthesia
- ASA physical status I-III
- Planned use of regional anesthesia with an adductor canal block as part of multimodal analgesia
- Ability to communicate pain intensity using the NRS scale
- Written informed consent obtained from the patient
You will not qualify if you...
- Refusal or inability to provide informed consent
- Allergy, intolerance, or contraindication to local anesthetics (ropivacaine)
- Pre-existing significant neurological deficit or neuropathy in the operative limb
- Coagulopathy or anticoagulation that contraindicates peripheral nerve blocks (e.g., INR >1.5, platelets <100,000/µL, or therapeutic anticoagulation that cannot be safely paused)
- Infection at or near the planned needle insertion sites
- Severe hepatic or renal impairment
- Chronic opioid therapy (>30 days of daily opioid use before surgery)
- Cognitive impairment or delirium preventing reliable pain assessment
- BMI > 40 kg/m² (optional)
- Previous knee arthroplasty on the same side or revision TKA
- Pregnancy or breastfeeding
- Participation in another interventional clinical trial within 30 days
AI-Screening
AI-Powered Screening
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Trial Site Locations
Total: 1 location
1
Poznan University of Medical Sciences
Poznan, Poland, 62-701
Actively Recruiting
Research Team
M
Malgorzata Reysner, MD PhD
CONTACT
How is the study designed?
Study Type
INTERVENTIONAL
Masking
QUADRUPLE
Allocation
RANDOMIZED
Model
PARALLEL
Primary Purpose
TREATMENT
Number of Arms
2
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