Ultrasound-Guided Local Anesthetic Infiltration Between the Popliteal Artery and the Capsule of the Posterior Knee (IPACK) Block for Primary Total Knee Arthroplasty: A Systematic Review of Randomized Controlled Trials

Local Reg Anesth. 2021 May 12;14:85-98. doi: 10.2147/LRA.S303827. eCollection 2021.ABSTRACTPosterior knee pain after total knee arthroplasty (TKA) is common despite multimodal analgesia and regional anesthesia use. This review included randomized controlled trials (RCTs) comparing analgesic outcomes after inclusion of local anesthetic infiltration between the popliteal artery and capsule of the knee (iPACK) block versus pathways without iPACK. Electronic databases (MEDLINE, Cochrane Library, Web of Science, Scopus) were searched from inception to 10/11/2020. Eligible studies evaluated iPACK use on primary outcomes: opioid consumption and pain scores with movement. Secondary outcomes included rest pain, patient satisfaction, length of stay (LOS), gait distance, knee range of motion (ROM), and complications. Bias and quality were appraised using the Cochrane Risk of Bias tool and Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) guidelines. Eight RCTs (777 patients) were included. iPACK block use demonstrated similar opioid consumption in the PACU (4/7 RCTs) and 24 hours after TKA (5/7 RCTs) compared to without iPACK (moderate-quality GRADE evidence). Additionally, iPACK block use demonstrated lower movement pain scores in PACU (3/5 RCTs) but similar or higher pain scores after 24 hours (5/7 RCTs; low-quality GRADE evidence). Studies consistently reported no difference in gait distance (4/4 RCTs) or complications (7/7 RCTs) between treatment arms (hig...
Source: Local and Regional Anesthesia - Category: Anesthesiology Authors: Source Type: research

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Publication date: Available online 8 October 2020Source: Anaesthesia Critical Care &Pain MedicineAuthor(s): Paul J. Zetlaoui, Elodie Gauthier, Dan Benhamou
Source: Anaesthesia, Critical Care and Pain Medicine - Category: Anesthesiology Source Type: research
Conditions:   Anesthesia;   Postoperative Pain;   Ultrasound Therapy; Complications Interventions:   Procedure: Intrathoracic Intercostal Nerve Block;   Procedure: Erector Spinae Plane Block Sponsor:   National Taiwan University Hospital Not yet recruiting
Source: ClinicalTrials.gov - Category: Research Source Type: clinical trials
Conclusions: A single injection of ultrasound-guided RLB did not reduce postoperative analgesic requirements following breast surgery. PMID: 32989202 [PubMed]
Source: Korean Journal of Pain - Category: Anesthesiology Tags: Korean J Pain Source Type: research
Background: Ultrasound-guided locoregional nerve blocks have been recently used in patients undergoing surgery for breast cancer. In particular, Paravetrebral block (PVB) and newer Pectoralis nerve (PECS) blocks can be used with the main aims of improving postoperative pain control and reducing use of opioids during general anesthesia. In this comparative study we investigated the effects of PVB and PECS in intraoperative opioid consumption, postoperative opioid consumption, postoperative nausea and vomiting (PONV), operative time, and post-operative hospital stay.
Source: European Journal of Cancer - Category: Cancer & Oncology Authors: Tags: POSTERS A: Local Regional Treatment – Surgery Source Type: research
Conclusion: The use of transmuscular QLB in patients undergoing total hip replacement decreased post-operative analgesic consumption and post-operative pain score and prolonged post-operative analgesia. It did not affect patients' satisfaction and occurrence of post-operative complications.
Source: Indian Journal of Anaesthesia - Category: Anesthesiology Authors: Source Type: research
This study wa...
Source: BMC Anesthesiology - Category: Anesthesiology Authors: Tags: Research article Source Type: research
Authors: Çakir Ö, Aksu C Abstract BACKGROUND/AIM: To compare the subjective level of pain in patients who underwent an ultrasound-guided percutaneous liver biopsy (PLB) after either pericapsular anesthesia (PA) or subcapsular anesthesia (SA), based on the Numeric Rating Scale (NRS). MATERIALS AND METHODS: A total of 323 patients, mean age 51, range 21-82 years; 160 (49.5%) male, referred to the Interventional Radiology Clinic of Kocaeli University Faculty of Medicine for image-guided PLB, between June 2019 and May 2020 were included and randomized into two groups by anesthetic type; the first (n=171...
Source: Turkish Journal of Medical Sciences - Category: General Medicine Tags: Turk J Med Sci Source Type: research
Conclusion: SAP block with continuous catheter technique seems to be a safe and effective modality for the management of acute postoperative pain after thoracotomy.
Source: Saudi Journal of Anaesthesia - Category: Anesthesiology Authors: Source Type: research
Conclusion: TPVB and SAP group result in a greater spread of the drug and provide equivalent analgesia and are superior to the PECS II block in providing analgesia for breast surgeries. SAP block is easier to perform than TPVB with lesser chances of complications and results in faster onset.
Source: Saudi Journal of Anaesthesia - Category: Anesthesiology Authors: Source Type: research
Conclusion: SAP block with continuous catheter technique seems to be a safe and effective modality for the management of acute postoperative pain after thoracotomy.
Source: Saudi Journal of Anaesthesia - Category: Anesthesiology Authors: Source Type: research
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