• Abdul Sattar Narejo, Fatima Abdulwahab, Mansoor Aqil, Abdullah T Alsubaie, Hassan Y Hazazy, Tariq Alzahrani, Abdulaziz Aljurayyan, and Ahmed Thallaj.
• From the Department of Anesthesiology (Narejo, Abdulwahab, Aqil, Alsubaie, Alzahrani, Thallaj); from the Department of Orthopedic Surgery (Aljurayyan), King Saud University Medical City; and from the Department of Anesthesiology (Hazazy), Prince Sultan Military Medical City, Riyadh, Kingdom of Saudi Arabia.
• Saudi Med J. 2021 Oct 1; 42 (10): 1065-1071.

ObjectivesTo compare the efficacy of interspace between the popliteal artery and the capsule of the posterior knee (iPACK) block with periarticular local infiltration analgesia (LIA) to assess postoperative pain control and enhanced recovery after total knee arthroplasty (TKA).MethodsThis research was carried out at King Saud University Medical City, Riyadh, Saudi Arabia, from September 2020 to March 2021. Eighty Patients scheduled for elective unilateral TKA were randomized to receive either iPACK or periarticular LIA along with adductor canal block under spinal anesthesia. The primary outcome was postoperative pain score, and secondary outcomes included physical rehabilitation, duration of surgery, length of post-anesthesia care unit stay, hemodynamics, and length of hospital stay.ResultsThe pain score during activity in iPACK group was significantly lower compared to LIA group at 4 hours postoperatively, but no significant difference was observed at 24 or 48 hours. The timed up and go test took significantly longer for patients in LIA group at 4, 24, and 48 hours compared to those in iPACK group. No significant differences in knee range of motion were observed between the 2 groups at any point.ConclusionBased on our findings, iPACK block is an effective technique in reducing pain in the immediate postoperative period without affecting motor function, resulting in enhanced recovery following primary TKA.Copyright: © Saudi Medical Journal.

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