Influence of infiltration between the popliteal artery and capsule of the knee combined with adductor canal block on postoperative motor function in total knee arthroplasty
ZHU Cai-yan
CHEN Jian-ming
LIU Zhi-heng
LI Jun-jie
LIU Shi-hui
BAI Tao-yang
ZOU Ji-peng
LIU You-tan
Abstract：Objective To investigate the effect of continuous adductor canal block(CACB)combined with infil-tration between the popliteal artery and capsule of the knee(IPACK)or with sciatic nerve block(SNB)on motor function recovery in patients undergoing total knee arthroplasty(TKA).Methods Forty-two patients scheduled for initial TKA were randomly assigned to two groups:the CACB combined with IPACK group(IPACK group)and the CACB combined with SNB group(SNB group),with 21 patients in each group.Before general anesthesia induction,ultrasound-guided nerve blocks were performed using 0.25％ropivacaine:the IPACK group received CACB(30 mL)and IPACK block(30 mL),while the SNB group received CACB(30 mL)and SNB(30 mL).Both groups underwent continuous analgesia via catheterization in the adductor canal.The effectiveness of the block was confirmed before anesthesia induction.Postopera-tive outcomes recorded included time to first ambulation,resting and active Numeric Rating Scale(NRS)pain scores at the Post-Anesthesia Care Unit(PACU),at MAX0-24h,24 h,MAX24-48h,and 48 h,modified Bromage scores,Timed Up and Go(TUG)test results,range of motion(ROM),quadriceps strength,patient satisfaction,and adverse events.Results Both groups showed comparable NRS scores at most time points during resting and activity;however,the SNB group had a lower NRS score during activity in the PACU.Patients in the IP ACK group had significantly shorter time to first ambulation,better modified Bromage scores in the PACU,and superior ROM at 24 h and 48 h.Additionally,more patients in the IPACK group were able to complete the TUG test on postoperative day 1.There were no significant differ-ences between the two groups in quadriceps strength,patient satisfaction,length of hospital stay,or adverse events.Conclusion CACB combined with IPACK block enhances early motor function recovery post-TKA and provides compa-rable analgesia to CACB combined with SNB.This approach is recommended for broader clinical application.
Keywords：total knee arthroplastycontinuous adductor canal blockinfiltration between the popliteal artery and capsule of the kneesciatic nerve blockmotor function recovery
Publication Date：2024-11-28
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：7( 1457-1463 )