A comparative study between combined adductor canal and infiltration of the interspace between popliteal artery and the capsule of posterior knee blocks versus combined adductor canal and periarticular injection blocks after total knee arthroplasty

Appropriate perioperative pain management results in faster recovery and rehabilitation leading to better functional outcome in patients undergoing TKA. This has necessitated the development of multimodal analgesia regimens involving the use of both regional anesthesia and systemic analgesics.Postoperative pain management after total knee arthroplasty (TKA) continues to evolve with better treatment strategies being formulated to improve patient satisfaction, clinical outcomes and reduce opioid use in the immediate postoperative period. Peripheral nerve blockade has been reported to deliver optimal postoperative pain relief and is increasingly preferred in patients undergoing orthopedic procedures, and various different techniques such as sciatic nerve block, femoral nerve block and adductor canal block have been describedAdductor canal block (ACB) and infiltration between the popliteal artery and the posterior capsule of the knee (IPACK) are considered motor sparing peripheral nerve blocks that can be suitable for multimodal analgesic pathways for knee arthroplasty. The objective of this study is to evaluate the efficacy of an IPACK block supplementing ACB block versus ACB and periarticular injection Blocks on postoperative pain scale scores, opioid consumption, performance during early physical therapy in patients undergoing total knee arthroplasty.