A distinction must be made between pain at rest (independent of stimulus) which may be as high as 40% and the pain caused by motion (stimulus-dependent pain) which may be as high as 95% in the first 3 days after surgery, delaying early patient rehabilitation. 2Ī high percentage of patients experience intense pain following TKA, and this percentage is among the highest of all surgical procedures. 1 Despite the excellent outcomes that can be achieved in patients taken to TKA, postoperative recovery continues to pose a significant challenge. The goal of this surgery is to eliminate pain, restore joint mobility and function of muscles, ligaments, and other soft tissues. Total knee arthroplasty (TKA) or total knee replacement is one of the most frequent procedures performed by orthopedic surgeons. Conclusión:Įl IPACK, combinado con el bloqueo femoral y la anestesia neuroaxial, resultan ser una excelente estrategia analgésica para logar un adecuado control del dolor en ATR, pronta rehabilitación y deambulación temprana del paciente. El 81% de los pacientes logró caminar en las primeras 24 hours. En el 73% de los casos no se requirió una dosis de opioide de rescate. La puntuación del dolor se mantuvo en una escala leve en un rango de 1–3 durante las 48 hours de seguimiento. Resultados:Įn total, 27 pacientes a quienes se les realizó ATR obtuvieron bloqueo IPACK.
Se informar los resultados de forma descriptiva. Se evaluaron las características sociodemográficas, antropométricas, lateralidad, dolor postoperatorio y consumo de opioides, satisfacción del paciente y del cirujano, náuseas y vómito postoperatorio, caminata en las primeras 48 h. Se realizó un estudio de cohorte prospectivo, en adultos llevados a ATR, durante 6 meses. Objetivo:ĭescribir el control analgésico, consumo de opioides y movilidad de pacientes programados para ATR usando bloqueo IPACK como adyuvante analgésico al bloqueo femoral. Por lo anterior, se decidió evaluar en una cohorte las cualidades analgésicas del bloqueo IPACK como una técnica emergente prometedora. Con las técnicas convencionales de bloqueo periférico para el compartimiento posterior se ha reportado pie caído y déficit motor distal. Resumen Introducción:Įl control del dolor en artroplastia total de rodilla (ATR) es determinante en el proceso de rehabilitación del paciente. The IPACK block, combined with femoral block and neuraxial anesthesia, turn out to be an excellent analgesic strategy for TKA, achieving adequate pain management, prompt rehabilitation, and early ambulation of the patient. In 73% of the cases, an opioid rescue dose was not required 81% of the patients managed to walk in the first 24 hours. The pain score remained in a mild level during the 48 hours of evaluation.
Twenty-seven patients taken to TKA received an IPACK block. Sociodemographic and anthropometric characteristics, laterality, postoperative pain, and opioid consumption, patient and surgeon satisfaction (Likert), postoperative nausea and vomiting, and walk in the first 24 hours, were evaluated and reported with a descriptive analysis. We conducted a prospective observational cohort study over a 6-month period in adults taken to TKA. To describe analgesic control, opioid consumption, and mobility of patients scheduled for TKA using IPACK block as adjunct analgesic to the femoral block. The infiltration between popliteal artery and capsule of the knee (IPACK) block is a promising emerging analgesic technique. With conventional peripheral blocking techniques for the posterior compartment, foot drop, and distal motor deficit have been reported. Pain control in total knee arthroplasty (TKA) is a determining factor in the patient's rehabilitation process.
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Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's Website ( This is an open access article under the CC BY-NC-ND license ( ). Supplemental digital content is available for this article. Read the Spanish version of this article at. IPACK block: emerging complementary analgesic technique for total knee arthroplasty.
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How to cite this article: Caballero-Lozada AF, Gómez JM, Ramírez JA, Posso M, Zorrilla-Vaca A, Lasso LF. AAnesthesiology Department, Universidad del Valle, Cali, ColombiaīAnesthesiology Department, Hospital San José de Buga, Buga, ColombiaĬAnesthesiology Department, Centro Médico Imbanaco, Cali, Colombia.Ĭorrespondence: Departamento de Anestesiología y Reanimación, Universidad del Valle, Calle 4B No.
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