Less pain post TKA with addition of peripheral nerve blocks

April 19, 2018

(HealthDay)—Addition of an interspace between the popliteal artery and capsule of the posterior knee (IPACK) block and adductor canal block (ACB) to periarticular injection (PAI) is associated with less pain after total knee arthroplasty (TKA), according to a study presented at the 2018 World Congress on Regional Anesthesia and Pain Medicine, held from April 19 to 21 in New York City.

David Kim, M.D., from the Hospital for Special Surgery in New York City, and colleagues conducted a double-blind trial involving patients undergoing TKA who were randomized to either a PAI (control; 43 patients) or an IPACK with an ACB and modified PAI injection (intervention; 43 patients).

The researchers found that intervention patients reported lower numeric rating scale on ambulation than the control group on postoperative day (POD) one (1.7 versus 5.0; P < 0.001); significant differences were also seen on PODs zero and two (1.7 versus 5.2 [P < 0.001] and 4.5 versus 5.5 [P = 0.025], respectively). Significantly lower pain scores were also reported after physical therapy on POD zero and one in the intervention group (1.9 and 1.4, respectively; P < 0.001). Patients who received the intervention also had less opioid consumption, less intravenous opioids, and less intravenous patient controlled analgesia.

"This study strongly supports addition of IPACK block and ACB to a multimodal analgesic pathway," the authors write.

Explore further: Periarticular injection superior to epidural analgesia in TKA

More information: More Information

Related Stories

Periarticular injection superior to epidural analgesia in TKA

October 1, 2014
(HealthDay)—For patients undergoing total knee arthroplasty, periarticular injection is superior to epidural analgesia for pain control, according to a study published in the Sept. 3 issue of The Journal of Bone & Joint ...

Peri-op IV corticosteroids benefit knee, hip arthroplasty

September 14, 2017
(HealthDay)—Intravenous corticosteroids are both safe and effective when used perioperatively in total knee or hip arthroplasty, with benefits including less pain, vomiting, and nausea, and fewer opioids, according to a ...

Multimodal approach to pain management reduces opioids, prescriptions after joint replacement

March 1, 2018
A multimodal approach to pain management (using two or more different methods or medications to manage pain) rather than using opioids alone was associated with a decrease in opioid use, opioid prescriptions and common opioid-related ...

Gabapentin doesn't cut use of morphine post-knee arthroplasty

November 27, 2013
(HealthDay)—The addition of gabapentin to patient-controlled analgesia (PCA) protocol does not reduce morphine consumption, pain, or opioid-related side effects in patients undergoing total knee arthroplasty, according ...

Bariatric surgery lessens knee OA pain more in certain patients

April 1, 2018
(HealthDay)—Laparoscopic gastric band (LAGB) surgery is associated with more improvement in knee osteoarthritis (OA) in younger patients and those without prior knee injury, according to a study published recently in Seminars ...

No link between pre-op cholesterol, post-op pain

December 13, 2017
(HealthDay)—Preoperative levels of serum total cholesterol (TC) do not correlate with postoperative pain following laparoscopic surgery for gastric cancer, according to research published online Nov. 23 in PAIN Practice.

Recommended for you

Surgery, not antibiotics, should remain first-line treatment for appendicitis: study

November 14, 2018
Treating appendicitis with antibiotics as an alternative to surgical removal of the inflamed organ was found to be more costly in the long term and result in higher rates of hospital readmissions, according to a study by ...

Study finds that in treating obesity, one size does not fit all

November 13, 2018
Analyzing data from more than 2,400 obese patients who underwent bariatric weight-loss surgery, researchers identified at least four different patient subgroups that diverge significantly in eating behaviors and rate of diabetes, ...

Surgery patients use only 1/4 of prescribed opioids, and prescription size matters

November 7, 2018
Many surgeons write prescriptions for opioid pain medications four times larger than what their patients will actually use after common operations, a new study shows.

Minimally invasive surgery associated with worse survival for women with cervical cancer compared to open hysterectomy

October 31, 2018
When comparing standard-of-care surgical options for women with early-stage cervical cancer, two studies led by researchers at The University of Texas MD Anderson Cancer Center discovered that minimally invasive radical hysterectomy ...

Aspirin alone a good clot buster after knee surgery

October 22, 2018
When it comes to preventing blood clots after a knee replacement, good old aspirin may be just as effective as newer, more expensive drugs.

Amount of weight regain after bariatric surgery helps predict health risks

October 16, 2018
Measuring the percentage of weight regained following the maximum amount of weight lost after bariatric surgery can help predict a patient's risk of several serious health problems, according to a long-term, multicenter study ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.