Recently, peripheral nerve blocks such as femoral nerve block (FNB), adductor canal block (ACB), and sciatic nerve block have been used to control pain after total knee arthroplasty. Nonsteroidal analgesics, narcotic analgesics, patient-controlled analgesia, and periarticular multimodal drug injection (PMDI) have been used to relieve postoperative pain. Postoperative pain is an important factor affecting the outcome of surgery that can make rehabilitation difficult and limit the range of motion of the joint. Total knee arthroplasty is satisfactory for improving pain and recovery from arthritis, but many patients complain of postoperative pain. IPACK may be a better option than PMDI for controlling acute phase pain in patients undergoing total knee arthroplasty. No complications relating to the procedure occurred. The resting NRS measured at day 3 after surgery was also significantly lower in the IPACK group than in the PMDI group, and the NRS at 45° knee flexion measured from day 3 to day 5 showed a significant reduction in the IPACK group. NRS measured at rest and 45° knee flexion at days 1 and 2 after surgery was significantly lower in the IPACK group than in the PMDI group. We compared the postoperative pain numerical rating scale (NRS), the number of times patient-controlled analgesia was administered and the amount administered, the total amount of opioids given, and complications associated with the procedure between the two groups. MethodsĪmong patients who received total knee arthroplasty from June 2017 to December 2017, 50 who underwent ACB with additional IPACK and 50 who received ACB with additional PMDI were selected for this study.
The aim of this study is to compare the postoperative analgesic effect of infiltration between the popliteal artery and the capsule of the knee (IPACK) and the effect of periarticular multimodal drug injection (PMDI) in addition to adductor canal block (ACB) after total knee arthroplasty.
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