An interventional study of Local infiltration analgesia and Ultrasound-guided adductor canal block in Nerve Block and Neuromuscular Blockade, sponsored by Women's College Hospital. Not yet recruiting. Open to participants aged 18 Years to 85 Years. Per ClinicalTrials.gov, last updated 2025-07-16.
Sponsored by Women's College Hospital · Not applicable, Interventional, and Treatment
LIA is the mainstay of postoperative analgesia in patients having knee arthroplasty. The combination of ACB-iPACK blocks has also been proposed as an effective analgesic modality for total knee arthroplasty. However, whether combining these two modalities yields any important incremental analgesic benefit remains unclear. The investigators hypothesized that the addition of ACB and iPACK blocks to LIA will yield clinically important analgesic benefits compared to LIA alone in patients having total knee arthroplasty.
LIA is the mainstay of postoperative analgesia in patients having knee arthroplasty. Performed by surgeons, LIA provides effective postoperative pain relief and reduces opioid requirements. Similar analgesic benefits have also been attributed to adductor canal and iPACK blocks, which partially block sensory innervation to the knee and its posterior capsule. Performed by anesthesiologist preoperatively, these blocks have also been incorporated into the care standard in numerous centers. However, it is not clear whether adding the adductor canal and iPACK blocks yields any incremental analgesic benefits. The investigators aimed to evaluate the benefits of adding adductor canal and iPACK blocks to LIA in patients having total knee arthroplasty.
Women's College Hospital is the lead sponsor of 83 studies on the registry; 20 are open to participants now.
Counted across the registry records on this site, refreshed daily.
Exclusion Criteria:
Patients in this group will receive LIA intraoperatively, as per institutional standard. The injected solution will be comprised of 100cc Ropiv 2%, + Ketorolac 30 mg + Epinephrine 25 ug.
Procedure: Local infiltration analgesia
Patients in this group will receive LIA intraoperatively, as per institutional standard. The injected solution will be comprised of 100cc Ropiv 2%, + Ketorolac 30 mg + Epinephrine 25 ug. Patients in this group will also receive preoperative nerve blocks under ultrasound guidance. These will include: 1. Adductor canal block with 0.5% Ropivacaine w/epi 20 mL 2. iPack block with 0.25% Ropivacaine w/epi 10 mL
Procedure: Local infiltration analgesia · Procedure: Ultrasound-guided adductor canal block
Procedure: Local infiltration analgesia performed by surgeons.
Procedure: Ultrasound-guided adductor canal and iPACK blocks performed by anesthesiologists preoperatively.
Also known as: iPACK block
Postoperative pain at rest
Area under the curve
Time frame: over the first 24 hours
Quality of recovery (QoR-15)
Quality of Recovery (QR15) scores at 24 hours will be the second primary outcome. QR15 is a measurement of quality of recovery after surgery and anesthesia that has been psychometrically tested and validated. Reporting of outcome measures on a scale of 0 to 10 (0=None of the time and 10=All of the time). There are a total of 40 items/questions.
Time frame: 24 hours postoperatively
Mean opioid analgesic consumption
Postoperative cumulative oral morphine equivalent consumption during the first 24 hours
Time frame: 24 hours postoperatively
Time to first analgesic request
Time frame: Up to 48 hours following surgery
Pain Assessment (VAS)
Visual Analogue Scale(VAS) - Pain:Overall pain assessed at rest and on movement A continuous scale comprised of a 100mm (10cm) horizontal line, anchored by 2 verbal descriptions No Pain to Worst Pain
Time frame: at 0, 6, 12, 18 and 24 hours
Risk of opioid-related side effects
nausea, vomiting, pruritus, sedation
Time frame: Up until one month following nerve block
Block-related complications
vascular puncture, hematoma formation, intravascular injection, epidural anesthesia-bilateral sensory block
Time frame: Up until one month following nerve block
Satisfaction with pain management
A Patient Diary will be completed to assess overall satisfaction with analgesic technique 10 cm scale with "not satisfied at all" and "very satisfied" at either end
Time frame: at 24 hours
No study locations are listed for this record.
This study is not yet recruiting, as verified in Jul 2025. You cannot join it, but the record below documents what was studied.
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