IPACK (Interspace between the Popliteal Artery and the Capsule of the Posterior Knee) Block Combined with SACB (Single Adductor Canal Block) Versus SACB for Analgesia after Total Knee Arthroplasty
Objectives To evaluate the combination of the infiltration between the popliteal artery and the posterior capsule of the knee (iPACK) block and single adductor canal block (SACB) versus SACB for motor‐sparing knee analgesia effects after total knee arthroplasty (TKA). Methods PubMed, Ovid, Cochrane...
| Main Authors: | , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2022-11-01
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| Series: | Orthopaedic Surgery |
| Subjects: | |
| Online Access: | https://doi.org/10.1111/os.13263 |
| _version_ | 1811255573678653440 |
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| author | Xiumei Tang Xile Jiang Lei Lei Weitao Zhu Zhongmin Fu Duan Wang Jiali Chen Ning Ning Zongke Zhou |
| author_facet | Xiumei Tang Xile Jiang Lei Lei Weitao Zhu Zhongmin Fu Duan Wang Jiali Chen Ning Ning Zongke Zhou |
| author_sort | Xiumei Tang |
| collection | DOAJ |
| description | Objectives To evaluate the combination of the infiltration between the popliteal artery and the posterior capsule of the knee (iPACK) block and single adductor canal block (SACB) versus SACB for motor‐sparing knee analgesia effects after total knee arthroplasty (TKA). Methods PubMed, Ovid, Cochrane Library, and other databases were searched from the inception to January 2021. Randomized controlled trials (RCTs) comparing patients receiving iPACK plus SACB with patients receiving SACB after TKA were included. The included studies were assessed by two reviewers according to the Cochrane risk of bias criteria. Meta‐analysis was performed with STATA 13.0 software, the risk ratios (RR) and mean differences (MD) were used to compare dichotomous and continuous variables. The primary outcome was ambulation pain and secondary outcomes were rest pain, opioid consumption, function ability, clinical outcomes, and complications. Results Seven RCTs (304 knees in iPACK + SACB group; 305 knees in SACB group) were included. The follow‐up periods ranged from 2 days to 3 months. Pooled data indicated lower pain scores at ambulation (p < 0.0001) for iPACK + SACB. When comparing the pain scores of subgroups analyzed at specific periods, lower scores in subgroups within 12 h (at rest and ambulation) and after 48 h (at ambulation) were observed in the iPACK + SACB group. Analysis demonstrated greater reduction in morphine consumption (p = 0.007) in the iPACK + SACB group. The iPACK + SACB group is also superior to the SACB group regarding function ability, which included range of motion (ROM) (p = 0.001), time up to go (TUG) test (p = 0.030), and ambulation distance (p < 0.0001). No difference was found in clinical outcomes or complications. Conclusions With the iPACK added to SACB, pain scores, morphine consumption, functional ability were improved. Additional high‐quality studies are required to further address this topic. |
| first_indexed | 2024-04-12T17:25:56Z |
| format | Article |
| id | doaj.art-fd97b97048994ec19d4c0c7daf668d89 |
| institution | Directory Open Access Journal |
| issn | 1757-7853 1757-7861 |
| language | English |
| last_indexed | 2024-04-12T17:25:56Z |
| publishDate | 2022-11-01 |
| publisher | Wiley |
| record_format | Article |
| series | Orthopaedic Surgery |
| spelling | doaj.art-fd97b97048994ec19d4c0c7daf668d892022-12-22T03:23:18ZengWileyOrthopaedic Surgery1757-78531757-78612022-11-0114112809282110.1111/os.13263IPACK (Interspace between the Popliteal Artery and the Capsule of the Posterior Knee) Block Combined with SACB (Single Adductor Canal Block) Versus SACB for Analgesia after Total Knee ArthroplastyXiumei Tang0Xile Jiang1Lei Lei2Weitao Zhu3Zhongmin Fu4Duan Wang5Jiali Chen6Ning Ning7Zongke Zhou8West China School of Nursing, Sichuan University/Department of Orthopedics, West China Hospital Sichuan University Chengdu P.R. ChinaDepartment of Clinical Nutrition, West China Hospital Sichuan University Chengdu P.R. ChinaWest China School of Nursing, Sichuan University/Department of Orthopedics, West China Hospital Sichuan University Chengdu P.R. ChinaDepartment of Computer Science and Technology Sichuan University Chengdu P.R. ChinaWest China School of Nursing, Sichuan University/Department of Orthopedics, West China Hospital Sichuan University Chengdu P.R. ChinaDepartment of Orthopedics, Orthopedic Research Institute, West China Hospital Sichuan University Chengdu P.R. ChinaWest China School of Nursing, Sichuan University/Department of Orthopedics, West China Hospital Sichuan University Chengdu P.R. ChinaWest China School of Nursing, Sichuan University/Department of Orthopedics, West China Hospital Sichuan University Chengdu P.R. ChinaDepartment of Orthopedics, Orthopedic Research Institute, West China Hospital Sichuan University Chengdu P.R. ChinaObjectives To evaluate the combination of the infiltration between the popliteal artery and the posterior capsule of the knee (iPACK) block and single adductor canal block (SACB) versus SACB for motor‐sparing knee analgesia effects after total knee arthroplasty (TKA). Methods PubMed, Ovid, Cochrane Library, and other databases were searched from the inception to January 2021. Randomized controlled trials (RCTs) comparing patients receiving iPACK plus SACB with patients receiving SACB after TKA were included. The included studies were assessed by two reviewers according to the Cochrane risk of bias criteria. Meta‐analysis was performed with STATA 13.0 software, the risk ratios (RR) and mean differences (MD) were used to compare dichotomous and continuous variables. The primary outcome was ambulation pain and secondary outcomes were rest pain, opioid consumption, function ability, clinical outcomes, and complications. Results Seven RCTs (304 knees in iPACK + SACB group; 305 knees in SACB group) were included. The follow‐up periods ranged from 2 days to 3 months. Pooled data indicated lower pain scores at ambulation (p < 0.0001) for iPACK + SACB. When comparing the pain scores of subgroups analyzed at specific periods, lower scores in subgroups within 12 h (at rest and ambulation) and after 48 h (at ambulation) were observed in the iPACK + SACB group. Analysis demonstrated greater reduction in morphine consumption (p = 0.007) in the iPACK + SACB group. The iPACK + SACB group is also superior to the SACB group regarding function ability, which included range of motion (ROM) (p = 0.001), time up to go (TUG) test (p = 0.030), and ambulation distance (p < 0.0001). No difference was found in clinical outcomes or complications. Conclusions With the iPACK added to SACB, pain scores, morphine consumption, functional ability were improved. Additional high‐quality studies are required to further address this topic.https://doi.org/10.1111/os.13263IPACK (interspace between the popliteal artery and posterior capsule of the knee) blockRandomized controlled trialsSACB (single adductor canal block)Systematic review and meta‐analysisTotal knee arthroplasty |
| spellingShingle | Xiumei Tang Xile Jiang Lei Lei Weitao Zhu Zhongmin Fu Duan Wang Jiali Chen Ning Ning Zongke Zhou IPACK (Interspace between the Popliteal Artery and the Capsule of the Posterior Knee) Block Combined with SACB (Single Adductor Canal Block) Versus SACB for Analgesia after Total Knee Arthroplasty Orthopaedic Surgery IPACK (interspace between the popliteal artery and posterior capsule of the knee) block Randomized controlled trials SACB (single adductor canal block) Systematic review and meta‐analysis Total knee arthroplasty |
| title | IPACK (Interspace between the Popliteal Artery and the Capsule of the Posterior Knee) Block Combined with SACB (Single Adductor Canal Block) Versus SACB for Analgesia after Total Knee Arthroplasty |
| title_full | IPACK (Interspace between the Popliteal Artery and the Capsule of the Posterior Knee) Block Combined with SACB (Single Adductor Canal Block) Versus SACB for Analgesia after Total Knee Arthroplasty |
| title_fullStr | IPACK (Interspace between the Popliteal Artery and the Capsule of the Posterior Knee) Block Combined with SACB (Single Adductor Canal Block) Versus SACB for Analgesia after Total Knee Arthroplasty |
| title_full_unstemmed | IPACK (Interspace between the Popliteal Artery and the Capsule of the Posterior Knee) Block Combined with SACB (Single Adductor Canal Block) Versus SACB for Analgesia after Total Knee Arthroplasty |
| title_short | IPACK (Interspace between the Popliteal Artery and the Capsule of the Posterior Knee) Block Combined with SACB (Single Adductor Canal Block) Versus SACB for Analgesia after Total Knee Arthroplasty |
| title_sort | ipack interspace between the popliteal artery and the capsule of the posterior knee block combined with sacb single adductor canal block versus sacb for analgesia after total knee arthroplasty |
| topic | IPACK (interspace between the popliteal artery and posterior capsule of the knee) block Randomized controlled trials SACB (single adductor canal block) Systematic review and meta‐analysis Total knee arthroplasty |
| url | https://doi.org/10.1111/os.13263 |
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