Observing Pain Relief and Recovery After Total Knee Replacement Using Sacral ESP and Other Nerve Blocks

What this Trial Is About

Researchers are evaluating the effectiveness and recovery outcomes of two combinations of locoregional anesthesia in adults over 18 years old undergoing unilateral total knee arthroplasty TKA under spinal anesthesia. The study compares the combination of adductor canal block ACB with sacral erector spinae plane ESP block to ACB combined with iPACK block. It aims to determine whether the ACB plus sacral ESP block provides effective pain relief and postoperative recovery. Participants receive spinal anesthesia and multimodal postoperative pain management, including paracetamol and rescue tramadol. The sacral ESP block is administered at the S2 level using ultrasound guidance and ropivacaine, while ACB and iPACK blocks follow standard protocols. Patients already receiving ACB plus sacral ESP block as part of their care will be observed for up to 48 hours after surgery. During the study, researchers will monitor recovery quality using the QoR-15 score at 24 hours, measure pain levels at rest and during movement over 48 hours, track time to first mobilization, analgesic consumption, and patient satisfaction. They will also watch for any complications related to the nerve blocks. The study lasts up to 30 months, and all data collection respects patient privacy and ethical standards.

The Sacral Erector Spinae Plane Block in Total Knee Arthroplasty