Evaluation of Utility of Ultrasound Guided iPACK Block for Knee Extension After Total Knee Arthroplasty.
Condition: Knee Osteoarthritis; Primary Total Knee Arthroplasty; Physical Therapy; Pain; Knee Extension
MeSH terms: Osteoarthritis; Osteoarthritis, Knee
Intervention: Ropivacaine; Interspace Between the Popliteal Artery and Capsule of the Knee (iPACK) Block; Saline
Intervention description: Local anesthetic (numbing drug); An ultrasound guided nerve block using a numbing medication called ropivacaine that numbs the nerves to the back of the knee.; An ultrasound guided nerve block using a medication that does NOT numb the nerve called saline, or salt water.
Intervention MeSH terms: Ropivacaine
Phase: Phase 4
Study type: Interventional
Primary purpose: Supportive Care
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Double (Participant, Investigator)
Enrollment: 50.0
Sex: All
Minimum age: 18 Years
Maximum age: 75 Years
Healthy volunteers: No
Keywords: iPACK; Interspace between the Popliteal Artery and Capsule of the Knee; Posterior Capsule block; Nerve Block

Summary:

      The purpose of this study is to learn if using an Interspace between the Popliteal Artery and
      Capsule of the Knee (iPACK) injection technique (also called a "nerve block") that numbs the
      nerves going to the back part of the knee to aid in physical therapy after surgery. The iPACK
      technique uses a numbing solution (local anesthetics) that is injected behind the knee to
      reduce pain and to help straighten the knee. This block may affect movement in the leg and
      make the legs weak, but thing is rare. A few institutions use the iPACK block for patients
      having total knee replacements, with the hope of providing good pain relief combined with
      improved mobility after surgery.
    

Eligibility criteria:

        Inclusion Criteria:

          -  English speaking

          -  Between 18 and 75 years old

          -  American Society of Anesthesiologists (ASA) 1-3 patients undergoing primary total knee
             arthroplasty

        Exclusion Criteria:

          -  ASA 4 or 5

          -  Revision knee arthroplasty

          -  Diagnosis of chronic pain

          -  Daily chronic opioid use (over 3 months of continuous opioid use)

          -  Inability to communicate pain scores or need for analgesia

          -  Acute knee dislocation/fracture

          -  Infection at the site of block placement

          -  Age under 18 years old or greater than 75 years old

          -  Pregnant women

          -  Intolerance/allergy to local anesthetics

          -  Weight <50 kg

          -  Suspected, or known addiction to or abuse of illicit drug(s), prescription
             medicine(s), or alcohol within the past 2 years.

          -  Uncontrolled anxiety, schizophrenia, or other psychiatric disorder that, in the
             opinion of the investigator, may interfere with study assessments or compliance

          -  Current or historical evidence of any clinically significant disease or condition
             that, in the opinion of the investigator, may increase the risk of surgery or
             complicate the subject's postoperative course.