IPACK Versus Popliteal Sciatic Nerve Block in ACL Reconstruction

Study Overview
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Brief Summary
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This is a prospective study comparing femoral nerve block plus sciatic nerve block to femoral nerve block plus infiltration of the posterior knee capsule (IPACK) in patients undergoing arthroscopic anterior cruciate ligament reconstruction. Femoral nerve block via the adductor canal (FNB-AC) with IPACK may provide effective analgesia while avoiding the motor block involved with sciatic nerve block. The lack of motor block is important to facilitate postoperative ambulation and physical therapy.

Official Title
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Comparison of Postoperative Analgesic Efficacy of Adductor Canal Block With IPACK Versus Adductor Canal and Popliteal Sciatic Nerve Block in Patients Undergoing Arthroscopic Anterior Cruciate Ligament Reconstruction

Conditions
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Anterior Cruciate Ligament Tear

Intervention / Treatment
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* Drug: Ropivacaine injection


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Patients less than 21 years of age American Society of Anesthesiologists physical status I and II Undergoing elective anterior cruciate ligament reconstruction Exclusion Criteria: They are unable or unwilling to take part in the study History of allergy to any of the medications administered for the nerve block Contraindication to peripheral nerve block Patients who are unable to understand instructions or questions related to the study or the families required language interpretation Patients who consume opioid medications for more than three days per week for more than a month prior to surgery

Ages Eligible for Study
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Maximum Age: 21 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Active Comparator: FNB-AC + Sciatic nerve block<br>Patients will receive up to 20 mL of 0.2% ropivacaine for FNB-AC and up to 20 mL of 0.2% ropivacaine for sciatic nerve block under ultrasound guidance. | Drug: Ropivacaine injection<br>* Total dose not to exceed 3 mg/kg of ropivacaine.<br>|
| Experimental: FNB-AC + IPACK<br>Patients will receive up to 20 mL of 0.2% ropivacaine for FNB-AC and up to 20 mL of 0.2% ropivacaine for posterior knee capsular infiltration under ultrasound guidance (IPACK) | Drug: Ropivacaine injection<br>* Total dose not to exceed 3 mg/kg of ropivacaine.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Average Post-operative Pain Score | Visual Analogue Scale (VAS) pain scores (0 being no pain and 10 being worst pain) from arrival to post-anesthesia care unit (PACU) to 48 hours after discharge from surgery center. | Immediately post-operatively and up to 48 hours post-discharge, an average of 48 hours | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Number of Opioid Doses Administered | Number of doses of narcotic pain medicine administered during surgery and up to 48 hours after discharge from surgery center. | Intra-operative and up to 48 hours post-discharge, an average of 48 hours |