Comparison of Techniques Combined of Blockades Peripheral Devices for Pain Management in Total Knee Replacement (TKR)
Pujato Sebastián*, Morra Jonnathan, Orellana kenneth and Deganutti Luciano
ABSTRACT
Introduction: Patients undergoing TKR frequently experience severe pain in the immediate postoperative period. Peripheral nerve blocks, in the context of multimodal analgesia, have been used to mitigate pain, provide comfort and accelerate the functional recovery of the patients. This research compares IPACK, ACB and PAI blocks as techniques to provide adequate analgesia avoiding muscle weakness.
Materials and Methods: Experimental, prospective, randomized double-blind study. 100 patients undergoing TKR were studied during the period 2020 to 2022, divided into two groups of 50 patients each. Group 1: ACB plus IPACK and group 2: ACB plus PAI. The visual analog scale (VAS) was used to assess pain. Opioid rescues, degree of satisfaction, range of motion and distance traveled postoperatively were quantified.
Results: Both groups were homogeneous in demographic data and duration of surgery (p>0.05). Group 1 patients required fewer opioid rescues (p=0.02) and had a shorter hospital stay (p=0.04). The time factor showed statistical differences in the perception of pain (p=0.001), but not the group factor (p>0.05). No statistically significant differences were obtained in terms of general satisfaction with the applied techniques, distance traveled or range of movement evaluated between 24 and 48 hours of the postoperative.
Conclusions: The combination of ACB block plus IPACK showed better clinical and functional results for the approach of postoperative analgesia in TKR.
