Scholarlink

Background <p>Nerve blocks are effective in reducing postoperative opioid use and enhancing rehabilitation following total knee arthroplasty. However, few studies compare the analgesic efficacy and functional recovery of adductor canal block (ACB) combined with infiltration between the popliteal artery and the capsule of the knee (iPACK) versus sciatic and femoral nerve blocks (S + F). This study hypothesized that ACB combined with iPACK (A + I) provides comparable analgesia to S + F with superior motor recovery.</p> Methods <p>Data were obtained from a prospectively maintained acute pain service database. After exclusion criteria were applied, 126 patients were analyzed. Propensity-score matching balanced baseline characteristics between the A + I and S + F groups. Numeric rating scale (NRS) scores at different time points were primary outcome. Motor function analysis, including the motor blockade, maximum flexion angle and time to ambulation were secondary outcomes.</p> Results <p>After propensity score matching, patients in the A + I group reported significantly lower NRS pain scores in the post-anesthetic care unit (1.00 ± 0.72 vs. 1.52 ± 1.34; <i>P</i> = 0.026) and on postoperative day 1 at rest (0.66 ± 0.71 vs. 1.07 ± 0.95; <i>P</i> = 0.025) and during movement (1.75 ± 0.75 vs. 2.43 ± 1.19; <i>P</i> = 0.002). Movement-associated pain on postoperative day 2 was also lower in the A + I group (1.45 ± 0.66 vs. 2.34 ± 0.91; <i>P</i> &lt; 0.001). The A + I group exhibited significantly less motor blockade (<i>P</i> &lt; 0.001) and achieved earlier ambulation (1551.75 ± 379.98 vs. 2031.95 ± 764.77&#xa0;min; <i>P</i> &lt; 0.001).</p> Conclusions <p>The A + I regimen demonstrated superior analgesic efficacy, reduced motor blockade, and earlier ambulation compared to S + F in TKA patients. These findings support the use of A + I for improved recovery.</p> Trial registration <p>This trial was registered before collection of data and analysis at ClinicalTrials.gov (NCT06521619). Date of registration: 2024-07-26.</p>

错误：搜索内容不能为空，请输入英文关键词
错误：关键词超出字数限制，请精简
高级检索

Comparative analysis of adductor canal block combined with iPACK block versus femoral combined with sciatic nerve blocks: a propensity score matched study

  • 期刊论文

  • 出版模式：

    开放获取

  • 发表日期：

    2025年5月16日

查看全文
  • Chao-Hsien Sung,
  • Jen-Hao Liu,
  • Chi-Feng Hung,
  • Chun-Hsien Fu

摘要

Background

Nerve blocks are effective in reducing postoperative opioid use and enhancing rehabilitation following total knee arthroplasty. However, few studies compare the analgesic efficacy and functional recovery of adductor canal block (ACB) combined with infiltration between the popliteal artery and the capsule of the knee (iPACK) versus sciatic and femoral nerve blocks (S + F). This study hypothesized that ACB combined with iPACK (A + I) provides comparable analgesia to S + F with superior motor recovery.

Methods

Data were obtained from a prospectively maintained acute pain service database. After exclusion criteria were applied, 126 patients were analyzed. Propensity-score matching balanced baseline characteristics between the A + I and S + F groups. Numeric rating scale (NRS) scores at different time points were primary outcome. Motor function analysis, including the motor blockade, maximum flexion angle and time to ambulation were secondary outcomes.

Results

After propensity score matching, patients in the A + I group reported significantly lower NRS pain scores in the post-anesthetic care unit (1.00 ± 0.72 vs. 1.52 ± 1.34; P = 0.026) and on postoperative day 1 at rest (0.66 ± 0.71 vs. 1.07 ± 0.95; P = 0.025) and during movement (1.75 ± 0.75 vs. 2.43 ± 1.19; P = 0.002). Movement-associated pain on postoperative day 2 was also lower in the A + I group (1.45 ± 0.66 vs. 2.34 ± 0.91; P < 0.001). The A + I group exhibited significantly less motor blockade (P < 0.001) and achieved earlier ambulation (1551.75 ± 379.98 vs. 2031.95 ± 764.77 min; P < 0.001).

Conclusions

The A + I regimen demonstrated superior analgesic efficacy, reduced motor blockade, and earlier ambulation compared to S + F in TKA patients. These findings support the use of A + I for improved recovery.

Trial registration

This trial was registered before collection of data and analysis at ClinicalTrials.gov (NCT06521619). Date of registration: 2024-07-26.