Does PAI Reduce Pain After TKA Among Knee Arthroplasty Patients Receiving ACB & IPACK?
Status:
Recruiting
Trial end date:
2022-07-01
Target enrollment:
Participant gender:
Summary
Kim et al (2019) have shown that addition of ACB/IPACK to PAI improves analgesic outcomes
(the nerve blocks reduced pain with ambulation and reduced opioid consumption). TKA patients
receiving PAI + ACB/IPACK (along with a comprehensive multimodal analgesic program) had low
pain scores with ambulation on POD1: 1.7 +/- 1.4 (mean +/- SD, NRS, 0-10 scale). The opioid
consumption in the first 24 hours was 40.6 +/- 32.1 (mg oral morphine equivalents).
It is not clear if the PAI component is necessary, given the theoretically nearly complete
analgesic effects of the ACB/IPACK block. Additionally, anecdotal evidence indicates that
some surgeons at HSS routinely use the PAI and some do not, without obvious large differences
in analgesic outcomes. While there may be a 'belt and suspenders' advantage to using PAI in
addition to ACB/IPACK, it is not desirable to perform unnecessary procedures.
In this study, we seek to compare the efficacy of ACB/IPACK with and without PAI in TKA
patients.