2024, Vol. 7, Issue 1, Part A

Background: The management of pain following knee surgeries is constantly advancing, as more effective therapeutic approaches are being developed to enhance patient' satisfaction, clinical outcomes, and minimize the usage of opioids postoperatively. This research examined the pain-relieving effects of combining adductor canal block (ACB) with infiltration of the space between the popliteal artery and the capsule of the posterior knee (IPACK) block after surgery, in comparison to genicular nerves block, among individuals having knee arthroscopy.

Patient and Methods: Thirty-five patients randomized in each group; control group, genicular nerves block group and ACB combined with I significantly PACK block group. First 24h postoperative morphine consumption, time till 1st rescue analgesic request, Numeric Rating Scale (NRS) score, Time Up and Go (TUG) score, Medical Research Council (MRC) score and satisfaction of patients had been evaluated.

Results: 24h post op. morphine consumption was significantly reduced in GNB group contrasted to ACB+IPACK and control groups (p< 0.05). NRS at rest & mobility was lower in GNB group contrasted to ACB+IPACK and control groups at 4, 6, 12, 18 and 24h post operatively. Time till 1st rescue analgesic request was significantly longer in GNB group contrasted to ACB+IPACK and control groups (p< 0.05). TUG was significantly reduced in GNB group contrasted to ACB+IPACK and control groups (p< 0.05). According MRC, quadriceps muscle was more powerful in GNB group patients compared to IPACK+ACB and control patients, patient satisfaction was greater in GNB group contrasted to ACB+IPACK and control groups.

Conclusion: Genicular nerves block provided less postoperative morphine consumption, longer duration of analgesia, better muscle power and lower pain score at rest and mobility than IPACK combined with ACB in patients undergoing Knee arthroscopy.