Actively Recruiting
Comparison of Adductor Canal Block Combined With Sacral Erector Spinae Plane Block Versus Adductor Canal Block Combined With iPACK Block in Patients Undergoing Total Knee Arthroplasty
Led by Poznan University of Medical Sciences · Updated on 2026-02-02
80
Participants Needed
1
Research Sites
4 weeks
Total Duration
On this page
AI-Summary
What this Trial Is About
Researchers are evaluating two different regional anesthesia methods to manage pain after total knee arthroplasty (TKA) in adults aged 65 and older. Both methods use an adductor canal block (ACB) to reduce pain while preserving muscle strength. The study compares combining ACB with either a sacral erector spinae plane block (S-ESPB) or an iPACK block to see which provides better pain relief, reduces opioid use, and improves recovery after surgery. Participants will receive an ultrasound-guided ACB with 20 mL of 0.2% ropivacaine. They will then be randomly assigned to receive either an S-ESPB or an iPACK block, both also using 20 mL of 0.2% ropivacaine. All patients will receive standard perioperative care and multimodal pain management as part of the study. The treatments aim to provide effective pain relief while allowing early movement after surgery. During the study, researchers will monitor the time until patients first need extra pain medication within 48 hours after surgery. They will also assess pain levels at rest and during movement, opioid use, muscle strength, nausea, blood pressure events, block-related complications, time to first mobilization, and patient satisfaction. The study will last from surgery through the 48-hour postoperative period with close observation of outcomes and side effects.
CONDITIONS
Brief 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
Complete this quick 3-step screening to check your eligibility
Your Study Journey
Duration - 2 to 4 weeks
Participants are screened for eligibility to participate in the trial.
1 visit (in-person)
Duration - Day of surgery
Participants undergo total knee arthroplasty and receive either an adductor canal block combined with sacral erector spinae plane block or an adductor canal block combined with iPACK block. Standard perioperative care and multimodal analgesia are provided.
1 visit (in-person) on surgery day
Duration - 48 hours
Participants are monitored for pain intensity, motor function, opioid consumption, and adverse events up to 48 hours after surgery.
Multiple assessments during hospital stay up to 48 hours
Duration - 30 days
Participants are observed for block-related adverse events for up to 30 days after surgery.
Follow-up assessments up to 30 days after surgery
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
How is the study designed?
Study Type
INTERVENTIONAL
Masking
QUADRUPLE
Allocation
RANDOMIZED
Model
PARALLEL
Primary Purpose
TREATMENT
Number of Arms
2
Similar Trials
Frequently Asked Questions
Have more questions? Get in touch with our team for quick support
Not the Right Trial for You?
Explore thousands of other clinical trials that might be a better match.
Sign up to get personalized trial recommendations delivered to your inbox.
Already have an account? Log in here