Systematic review of the QoR-15 score, a patient- reported outcome measure measuring quality of recovery after surgery and anaesthesia.
J Kleif, J Waage, K B Christensen...
https://pubmed.ncbi.nlm.nih.gov/29397134Actively Recruiting
Phase Not Applicable
Age: 18Years - 75Years
All Genders
ID07248072
Effects of iPACK and Biceps Femoris Short Head (BiFeS) Blocks Combined With Adductor Canal Block on Quality of Recovery After Total Knee Arthroplasty
Led by Ataturk University · Updated on 2026-05-18
74
Participants Needed
1
Research Sites
N/A
Total Duration
On this page
AI-Summary
What this Trial Is About
Researchers are evaluating two different posterior knee pain relief methods—the iPACK block and the Biceps Femoris Short Head (BiFeS) block—when each is combined with an adductor canal block (ACB) in adults undergoing elective unilateral total knee replacement surgery. This clinical trial aims to assess which combination provides better postoperative recovery, focusing on improving pain management, mobility, and overall patient satisfaction after surgery. The study is a prospective, randomized, double-blind trial designed to produce high-quality evidence comparing these two techniques. Participants will be randomly assigned to one of two groups: one receiving the ACB plus the iPACK block, and the other receiving the ACB plus the BiFeS block. Both blocks are performed under ultrasound guidance using specified doses of bupivacaine, with spinal anesthesia and standardized perioperative pain control measures also provided. The iPACK block targets the posterior knee capsule, while the BiFeS block focuses on the space between the femur and the short head of the biceps femoris muscle, aiming for selective posterolateral knee analgesia with limited motor involvement. During the study, participants will be monitored closely with assessments including the Quality of Recovery-15 score at 24 and 48 hours after surgery, pain scores at various intervals, opioid use, muscle strength tests, functional mobility tests, range of motion measurements, and time to first mobilization. Safety will be observed by tracking adverse events like nausea, neurological symptoms, and falls. The total study duration and follow-up focus primarily on the first 48 hours after surgery to evaluate recovery and analgesic effectiveness.
CONDITIONS
Brief Title
Effect of iPACK and BiFeS Blocks on Quality of Recovery After Total Knee Arthroplasty
Who Can Participate
Age: 18Years - 75Years
All Genders
Eligibility Criteria
You may qualify if you...
- Age 18 to 75 years
- Scheduled for elective primary unilateral total knee arthroplasty (TKA)
- Planned spinal anesthesia
- ASA physical status I-III
- Ability to understand study procedures and provide written informed consent
You will not qualify if you...
- Known allergy or hypersensitivity to local anesthetics or other study medications
- Coagulopathy or current anticoagulant therapy
- Severe hepatic, renal, or cardiac failure
- History of neuropathic pain
- Infection at the site of proposed nerve block
- Pre-existing neuromuscular disorders in the lower extremities
- Inability to cooperate or refusal to participate in the study
- Pregnancy
AI-Screening
AI-Powered Screening
Complete this quick 3-step screening to check your eligibility
1
2
3
Your Study Journey
Screening
Duration - 2 to 4 weeks
Participants are screened for eligibility to participate in the trial.
1 visit (in-person)
Treatment
Duration - Up to 48 hours postoperatively
Participants undergo total knee arthroplasty with spinal anesthesia and receive either an adductor canal block combined with an iPACK block or an adductor canal block combined with a BiFeS block for postoperative pain management.
1 day surgery visit plus multiple assessments within 48 hours after surgery
Follow-up
Duration - Up to 48 hours postoperatively
Participants are monitored for recovery quality, pain levels, muscle strength, functional performance, range of motion, time to mobilization, and adverse events after the blocks and surgery.
Assessments at 2, 4, 8, 12, 24, and 48 hours postoperatively
Trial Site Locations
Total: 1 location
1
Ataturk University
Erzurum, Turkey (Türkiye), 25000
Actively Recruiting
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Research Team
A
Ahmet Murat Yayık, Associate Professor
M
Mehmet Akif Yılmaz, assistant doctor
How is the study designed?
Study Type
INTERVENTIONAL
Masking
DOUBLE
Allocation
RANDOMIZED
Model
PARALLEL
Primary Purpose
TREATMENT
Number of Arms
2
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Published Research Related To This Trial
Ultrasound-guided biceps femoris short head block: a novel regional anesthesia technique for the posterolateral knee.
Alper Kilicaslan, Serkan Tulgar, Ali Ahiskalioglu...
https://pubmed.ncbi.nlm.nih.gov/40418224Ultrasound-Guided Biceps Femoris Short Head Block for Posterolateral Knee Analgesia After Total Knee Arthroplasty: A Case Report.
Elif Sarikaya Ozel, Mehmet Gokhan Taflan
https://pubmed.ncbi.nlm.nih.gov/40985541Adductor canal block versus femoral nerve block for analgesia after total knee arthroplasty: a randomized, double-blind study.
Pia Jæger, Dusanka Zaric, Jonna S Fomsgaard...
https://pubmed.ncbi.nlm.nih.gov/24121608Anaesthesia, surgery, and challenges in postoperative recovery.
Henrik Kehlet, Jørgen B Dahl
https://pubmed.ncbi.nlm.nih.gov/14667752Pain after knee arthroplasty: an unresolved issue.
Irina Grosu, Patricia Lavand'homme, Emmanuel Thienpont
https://pubmed.ncbi.nlm.nih.gov/24201900Knee replacement.
Andrew J Carr, Otto Robertsson, Stephen Graves...
https://pubmed.ncbi.nlm.nih.gov/22398175Minimal Clinically Important Difference for Three Quality of Recovery Scales.
Paul S Myles, Daniel B Myles, Wendy Galagher...
https://pubmed.ncbi.nlm.nih.gov/27159009Adductor Canal Block Combined With iPACK (Interspace Between the Popliteal Artery and the Capsule of the Posterior Knee) Block vs Periarticular Injection for Analgesia After Total Knee Arthroplasty: A Randomized Noninferiority Trial.
Wannida Kertkiatkachorn, Wirinaree Kampitak, Aree Tanavalee...
https://pubmed.ncbi.nlm.nih.gov/32694032The Interspace Between Popliteal Artery and Posterior Capsule of the Knee (IPACK) Block in Knee Arthroplasty: A Prospective Randomized Trial.
Mohammad A Abdullah, Mohamed M Abu Elyazed, Shaimaa F Mostafa
https://pubmed.ncbi.nlm.nih.gov/35652772