Comparing Two Posterior Knee Pain Relief Methods Combined With Adductor Canal Block in Adults Having Elective Unilateral Total Knee Replacement

What this Trial Is About

Researchers are evaluating two different posterior knee pain relief methodsthe iPACK block and the Biceps Femoris Short Head BiFeS blockwhen 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.

Effect of iPACK and BiFeS Blocks on Quality of Recovery After Total Knee Arthroplasty