Genicular Nerve Block Versus Its Combination With Infiltration Between Popliteal Artery and Capsule of Posterior Knee

Browse trials for

• Pain, Postoperative 5,093

Keywords

• genicular ,IPACK, total knee

Pain, Postoperative

5,093 studies on the registry are indexed under Pain, Postoperative; 1,140 are open to participants now.

This study's planned enrollment of 63 is below the median of 75 across 4,344 interventional studies indexed under Pain, Postoperative.

Lead sponsor

Zagazig University is the lead sponsor of 447 studies on the registry; 75 are open to participants now.

Of its 5 completed or terminated interventional studies of FDA-regulated products, 0 (0%) have results posted.

Study arms

• Active comparator
  C group

  the patients will take standard analgesia ( meloxicam (15 mg) once a day + paracetamol 1gm /3 times a day). ,with no nerve block

  Drug: standard analgesia (paracetamol and meloxicam)

• Active comparator
  G group

  the patients will take standard analgesia plus GNB

  Procedure: GNB plus standard analgesia · Drug: standard analgesia (paracetamol and meloxicam)

• Active comparator
  GI group

  the patients will take standard analgesia plus GNB plus IPACK

  Procedure: GNB plus IPACK block plus standard analgesia · Drug: standard analgesia (paracetamol and meloxicam)

Interventions

• ProcedureGNB plus standard analgesia

  When patients are in supine position with a pillow under the popliteal fossa, we will target points next to superior medial, superior lateral, and inferior medial genicular arteries to block the superior medial, superior lateral, and inferior medial branches of genicular nerve. For identification, we will use color Doppler near the periosteal areas (the junctions of the epicondyle with the shafts of the femur and tibia, accordingly). using a 12 MHz linear transducer (XarioTM SSA-660A, Toshiba Medical Systems Corporation, Otawara, Japan) positioned parallel to the shaft of the long bones in the legs, the needle will be inserted ( in plane technique in the long-axis view) and a 2.5 mL of bupivacaine (5%) will be injected at each target points.standard analgesia will be given post-operativelly (paracetamol 1 gm/ three times a daily and meloxicam (15 mg)once a day)

  Also known as: genicular block and standard analgesia

• ProcedureGNB plus IPACK block plus standard analgesia

  IPACK block will be done when the patients in supine position with the knee flexed in 45 degree. using a low frequency transducer at a depth of 3.5-4 cm positioned transversely, 2-3 cm above the patella and over the medial aspect of the knee, we will identify the distal part of the shaft of the femur and the popliteal artery with sliding the transducer proximally and distally (If the two femoral condyles appear first, proximal sliding of the probe, so the humps of the femoral condyles will disappeared and the flat metaphysis will appeared). With advancement of the needle in plane toward the space between the popliteal artery and the femur, 15 ml of bupivacaine 0.5% will be injected. The genicular nerve block will be done as in group G and standard analgesia will be given post-operative as in group G

  Also known as: genicular bock and IPACK block and standard analgesia

• Drugstandard analgesia (paracetamol and meloxicam)

  (paracetamol 1 gm 3 times a daily and meloxicam (15 mg) once aday.

  Also known as: standard analgesia with no nerve block

Primary outcomes

1. 2 hours visual analogue scale

   pain intensity at rest and with motion using visual analogue scale from " horizontal line of 10-cm long with two ends, one end indicate no pain 0 and the other end indicate worst pain 10".

   Time frame: at 2 hour postoperative.

2. 4 hours visual analogue score

   pain intensity at rest and with motion using visual analogue scale from " horizontal line of 10-cm long with two ends, one end indicate no pain 0 and the other end indicate worst pain 10".

   Time frame: at 4 hours postoperative

3. 6 hours visual analogue score

   pain intensity at rest and with motion using visual analogue scale from " horizontal line of 10-cm long with two ends, one end indicate no pain 0 and the other end indicate worst pain 10".

   Time frame: at 6 hours postoperative

4. 8 hours visual analogue score

   pain intensity at rest and with motion using visual analogue scale from " horizontal line of 10-cm long with two ends, one end indicate no pain 0 and the other end indicate worst pain 10".

   Time frame: at 8 hours postopertaive

5. 12 hours visual analogue score

   pain intensity at rest and with motion using visual analogue scale from " horizontal line of 10-cm long with two ends, one end indicate no pain 0 and the other end indicate worst pain 10".

   Time frame: at 12 hours postoperative

6. 18 hours visual analogue score

   pain intensity at rest and with motion using visual analogue scale from " horizontal line of 10-cm long with two ends, one end indicate no pain 0 and the other end indicate worst pain 10".

   Time frame: at 18 hours postoperative

7. 24 hours visual analogue score

   pain intensity at rest and with motion using visual analogue scale from " horizontal line of 10-cm long with two ends, one end indicate no pain 0 and the other end indicate worst pain 10".

   Time frame: at 24 hours postoperative

Secondary outcomes

1. • Time of performance of block

   defined as time from putting of U.S probe till the end of block procedure.

   Time frame: from putting of U.S probe till the end of block procedure

2. • Total morphine consumption

   Total morphine consumption

   Time frame: at 24 hours post-operatively

3. •incidence of Anticipated side effect

   nausea, vomiting, itching, hemorrhage, bradycardia and hypotension.

   Time frame: at 24,48 hours postoperative

4. degree of maximum active flexion and extension of the knee

   the angle of maximum active flexion and extension of the knee

   Time frame: at 24 hours post operative

5. walk test

   walking distance in meters that patients can wake during 2 min

   Time frame: at 24 hours post operative

6. holding quadriceps muscle

   number of patients capable to hold quadriceps muscle more than 5 seconds.

   Time frame: at 24 hours post operative

7. time up and go (TUG)

   the time required for the patient to stand up from a standard-height armchair, walk 3 meters, turn, walk back to the chair, and sit down

   Time frame: at 24 hours post operative