![]() ![]() Secondary outcomes are efficacy (measured Without the use of opioids at 4-6 hours after TKA. Walk 10 meters with assistance) with a numerical rating scale (NRS) of equal or less than 4 The primary study outcome is the proportion of patients that are able to mobilise (defined as II a Femoral Triangle - iPACK block and group III LIA. Trial with a randomization rate 1:1:1.Group I will receive a Genicular - iPACK block, group The study is a prospective, double-blind, triple-arm superiority pilot randomised controlled Primary TKA is superior to Femoral triangle - iPACK block and Local Infiltration Analgesia Short-term postoperative analgesic effect and ambulation after a Genicular - Infiltrationīetween Popliteal Artery and Capsule of Knee (iPACK) block in patients undergoing unilateral The investigators want to estimate treatments effects, inclusion rate, and feasibility ofĬonducting a future randomized controlled superiority trial and to assess whether the ![]() Motor-sparing analgesic interventions for patients undergoing total knee arthroplasty (TKA)Īre a key component of fast-track surgery. ![]() As there is no muscle weakness so the patient can participate in physical therapy early.Patients Per Site Per Month Study Details Study Description Brief Summary The main advantage of PENG block is that it provides better analgesia of the hip without causing any muscle weakness. These blocks also result in incomplete analgesia to the hip as here is sparing of few articular branches to the hip. These blocks result in weakness of quadriceps muscles and thus predispose to fall. Femoral nerve block, fascia iliaca compartment block, or lumbar plexus block have been used to manage post-operative analgesia in hip surgeries. It is performed in supine position by depositing 15-20 ml of local anesthetic in the plane between the psoas tendon and the pubic ramus under direct ultrasound visualization. PENG block is indicated for anterior hip arthroplasties, lateral hip arthroplasties, and for hip fractures. PENG block: The pericapsular nerve group (PENG) block is an interfascial plane block aiming to block articular branches supplied by femoral, obturator, and accessory obturator nerves. A total of 12 cc to 30 cc of local anesthetic is injected. A needle tip is placed next to the nerve roots. A needle is then placed in-plane or out-of-plane and directed toward the nerves. At the C6 nerves of the brachial plexus are visualized in a vertical orientation within the interscalene groove. The subclavian artery is identified by directing the beam towards the first rib. The carotid artery and internal jugular vein are visualized. A probe is placed in a transverse position with its long axis across the neck just above the clavicle if using ultrasound. Sternal notch, the sternal and clavicular heads of the sternocleidomastoid muscle, and clavicle are identified and marked. For positioning, the patient is placed in a supine position with the head turned away from the side of the block. Interscalene block: anesthetizes nerve roots from the cervical plexus (C3, C4, supraclavicular nerve) and upper and middle trunks of the brachial plexus (C5-C7). ![]() Also, intravenous access should be obtained due to the risk of potential complications like vasovagal events, local anesthetic toxicity, and the possible use of general anesthetics. Following the history and physical, the patient should be made familiar with the risks, benefits, and care needed during the recovery phase of the block.įor patients that are receiving a nerve block for a surgical procedure, they should follow the same fasting guidelines for the surgery as it may be necessary for deep sedation to be used in cases of an inadequate block. Studies show that patients with preexisting sensory or motor deficits may be more likely to develop new deficits following a block than patients without preexisting deficits. A thorough physical exam is prudent as well to determine preexisting sensory or motor deficits in the distribution of the block. Taking a detailed medical history is necessary to determine conditions like coagulopathy or respiratory compromise that may impact the decision to perform a block. ![]()
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