iPACK Block vs. Periarticular Infiltration for TKA Pain Control

Trial statusNot yet recruiting
Trial phaseNot listed
Trial typeObservational
Biological sexAll
Age18-80
SponsorTurgutlu State Hospital

About this trial

This study aims to retrospectively compare two different multimodal analgesic techniques for pain management after total knee arthroplasty (TKA). The primary purpose is to evaluate whether a combination of two specific nerve blocks administered by an anesthesiologist (Femoral Triangle Block + iPACK block) resulted in superior postoperative pain control compared to a hybrid combination of a nerve block and a local infiltration administered by the surgeon (FTB + Periarticular Infiltration \[PAI\]).

The hypothesis is that the FTB + iPACK combination is associated with a significant reduction in Numeric Rating Scale (NRS) pain scores with movement at 24 hours postoperatively. This is a retrospective, observational cohort study conducted at a single center, involving medical records of patients who underwent primary unilateral TKA. Data from patients who received either FTB + iPACK or FTB + PAI as part of their standard clinical care will be extracted and analyzed retrospectively.

Eligibility criteria

This trial does not accept healthy volunteers

Qualifiers

American Society of Anesthesiologists (ASA) physical status II-III.

Scheduled for elective, primary, unilateral total knee arthroplasty for osteoarthritis.

Able to provide written informed consent.

Disqualifiers

Patient refusal to participate or contraindication to regional anesthesia.

Known allergy to any study medications (local anesthetics, NSAIDs, tramadol, morphine, paracetamol).

History of chronic opioid use (defined as daily use for >3 months)

Pre-existing peripheral neuropathy in the operative limb.

Trial population

The study population consists of adult patients who underwent elective, primary, unilateral total knee arthroplasty (TKA) under spinal anesthesia at Turgutlu State Hospital. Patient records and institutional registries will be reviewed retrospectively to identify eligible cases managed within a specific operational period (e.g., between December 2025 and May 2026). The cohort includes patients who received either an ultrasound-guided Femoral Triangle Block combined with an iPACK block or a hybrid combination of Femoral Triangle Block and surgeon-administered Periarticular Infiltration for postoperative analgesia as part of standard clinical care.

Trial design

Design model

Cohort

Time perspective

Retrospective

Treatments tested in this trial

Not listed

Trial groups

100 Participants
are grouped into 2 trial groups
Group A: FTB + iPACK Group
Group B: FTB + PAI Group

Trial outcomes

Primary outcomes

1

Postoperative Pain Score with Movement at 24 Hours

Pain assessed via Numeric Rating Scale (NRS) during active movement (e.g., active knee flexion or straight leg raise). Scale: 0 (no pain) to 10 (worst pain imaginable).

Time frame
24 and 48. hours postoperatively

Secondary outcomes

1

Postoperative Pain Scores (Time-Course)

Numeric Rating Scale (NRS) for pain (0-10) assessed at rest and with movement.

Time frame
Assessed at 6, 12, and 24 hours postoperatively
2

Time to First Rescue Analgesia

Time (in minutes) from the end of surgery to the first patient request for rescue tramadol.

Time frame
First 24 postoperative hours
3

Time Up to Go Test

The time taken (in seconds) for the participant to stand up from a standard armchair, walk a distance of 3 meters, turn, walk back to the chair, and sit down. Lower values indicate better functional mobility.

Time frame
Assessed at 24 hours
4

Straight Leg Raise

Assessment of active quadriceps motor function. Defined as the participant's ability to actively lift the operated leg off the bed with the knee fully extended (straight). This will be assessed as a binary outcome (Success = Able to lift unassisted / Failure = Unable to lift).

Time frame
Postoperative 24. hour

Other outcomes

Sponsors and contacts

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