ABSTRACT
Background:
Several local
regional anesthesia regimes have been described in the
literature to reduce
post-surgical pain following
total knee arthroplasty (TKA), but it is unclear which regime has the best analgetic effect combined with the best motor function. The aim of this study was to determine if
patients with infiltration between the
popliteal artery and
capsule of the posterior
knee (IPACK) combined with an adductor canal block (SACB) had less
pain, better motor function, and less
opioid consumption after TKA than
patients with a
femoral nerve block (FNB) combined with a popliteal
sciatic nerve block (PSB).
Methods:
In a retrospective
cohort analysis, 342
patients following primary TKA were examined; 175
patients were treated with an IPACK combined with a SACB, and 167
patients with a femoral FNB combined with a PSB. The outcome
parameters postoperative pain (visual analogue scale (VAS) for mobilization and at
rest, functional recovery,
opioid consumption,
hospital discharge, and
complications were analyzed and compared between both groups.
Results:
The IPACK/SACB group had a higher postoperative need for
opioids despite higher doses of
ropivacaine compared to the FNB/PSB group, accompanied by higher VAS scores.
Patients'
satisfaction was equal between the groups. Both groups showed comparable mobilization rates and
walking distances following TKA.
Conclusions:
IPACK/SACB showed equal results compared to FNB/PSB for mobilization rates and
patients'
satisfaction following TKA without a reduction in
opioid consumption.
