Less pain post TKA with addition of peripheral nerve blocks
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 pain scores 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.
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