Liposomal Bupivacaine for Adductor Canal Block Combined with IPACK Block in Total Knee Arthroplasty: A Prospective, Double-Blind, Randomized Controlled Trial.
Qisong Yuan, Wang Shen, Wenbin He...
https://pubmed.ncbi.nlm.nih.gov/41858908Actively Recruiting
Phase Not Applicable
Age: 18Years - 80Years
All Genders
ID07509866
A Randomized Trial Comparing Liposomal Bupivacaine and Ropivacaine With Perineural Dexamethasone or Dexmedetomidine for Adductor Canal and IPACK Blocks in Total Knee Arthroplasty
Led by Huazhong University of Science and Technology · Updated on 2026-04-14
90
Participants Needed
1
Research Sites
8 weeks
Total Duration
On this page
AI-Summary
What this Trial Is About
Researchers are evaluating different pain management techniques for patients undergoing total knee arthroplasty (TKA). The study compares three local anesthetic approaches: liposomal bupivacaine alone, ropivacaine with perineural dexamethasone, and ropivacaine with perineural dexmedetomidine. These methods are used in adductor canal block (ACB) and infiltration between the popliteal artery and capsule of the knee (IPACK) blocks to provide motor-sparing analgesia. The goal is to find the optimal approach to improve pain control and reduce opioid use after surgery. Participants will be randomly assigned to one of two groups: one receiving liposomal bupivacaine 6.65% and the other receiving ropivacaine 0.375% combined with either dexamethasone 4 mg or dexmedetomidine 1 mcg/kg. Each participant will receive a total of 40 mL of anesthetic divided equally between the ACB and IPACK blocks. These ultrasound-guided nerve blocks are administered before the surgical incision. During the study, researchers will monitor total opioid consumption over 72 hours as the main outcome. Additional assessments include pain scores at rest and movement, time to first ambulation, hospital stay duration, patient satisfaction with pain management, and quality of recovery. The study uses a quadruple-blind design to ensure unbiased results and will continue until December 2026. Participants undergo evaluations throughout their hospital stay and recovery period to track safety and effectiveness.
CONDITIONS
Brief Title
Liposomal Bupivacaine Versus Ropivacaine With Perineural Dexamethasone or Dexmedetomidine as Adjuncts for Adductor Canal Block Combined With IPACK Block in Total Knee Arthroplasty
Who Can Participate
Age: 18Years - 80Years
All Genders
Eligibility Criteria
You may qualify if you...
- Patients scheduled for elective primary unilateral total knee arthroplasty
- Age 18 years or older and 80 years or younger
- American Society of Anesthesiologists (ASA) physical status I-III
- Body mass index (BMI) between 18 kg/m8 and 35 kg/m8
- Ability to understand and provide written informed consent
You will not qualify if you...
- Known allergy or contraindication to local anesthetics (bupivacaine, ropivacaine), dexamethasone, dexmedetomidine, or opioids
- Infection at the injection site
- Coagulopathy or current use of anticoagulants
- Severe cardiovascular disease (NYHA class III or IV, or recent myocardial infarction within 6 months)
- Severe liver impairment (Child-Pugh class C) or kidney impairment (eGFR < 30 mL/min/1.73 m8)
- Uncontrolled hypertension (systolic > 180 mmHg or diastolic > 110 mmHg despite medical therapy)
- Uncontrolled diabetes mellitus (HbA1c > 8.5%)
- Bilateral or revision total knee arthroplasty
- Chronic opioid use (daily use for more than 3 months prior to surgery)
- Participation in another interventional clinical trial within 30 days prior to enrollment
- Inability to communicate with study personnel or complete pain assessments (e.g., language barrier, cognitive impairment)
AI-Screening
AI-Powered Screening
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2
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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 - Single day on the day of surgery
Participants receive ultrasound-guided adductor canal block (ACB) and IPACK block using one of the study drugs prior to surgery.
1 treatment visit (in-person)
Follow-up
Duration - Up to 30 days after surgery
Participants are monitored for pain scores, opioid use, ambulation, hospital stay duration, and recovery quality postoperatively.
Multiple visits including assessments at 24, 48, and 72 hours, and up to 30 days post-surgery
Trial Site Locations
Total: 1 location
1
Union Hospital, Tongji Medical College, Huazhong University of Science and Technology
Wuhan, Hubei, China, 430022
Actively Recruiting
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Research Team
X
Xi Wu
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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Nasir Hussain, Chad M Brummett, Richard Brull...
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