![]() ![]() At the hospital level, RAAPM experts can implement evidence-based multimodal analgesic clinical pathways featuring regional anesthesia. Although other outcomes were unchanged, there may be a role for new opioid-sparing analgesic techniques, and changing clinical practice change can occur rapidly.Ībstract: The subspecialty of regional anesthesiology and acute pain medicine (RAAPM) is in a position to lead changes that may impact the current opioid crisis. Conclusions Within a multimodal analgesic protocol, addition of IPACK blocks decreased the lowest pain scores on POD 0. The highest patient-reported pain scores on any POD were similar between groups with no differences in other outcomes. On POD 0, the lowest pain score (median ) was significantly lower for the POST group compared to the PRE group (0 vs. Results Post-implementation, 48/50 (96%) of TKA patients received an IPACK block, and they were compared with 32 patients in the PRE group. Other outcomes were daily pain scores, opioid consumption, ambulation distance, length of stay, and adverse events within 30 days. All TKA patients received adductor canal catheters and peri-operative multimodal analgesia. Methods With Institutional Review Board approval, we retrospectively reviewed data for consecutive TKA patients by a single surgeon 4 months before (PRE) and after (POST) IPACK implementation. We compared pain outcomes in TKA patients before and after implementation of the IPACK with the hypothesis that patients receiving IPACK blocks will report lower pain scores on postoperative day (POD) 0 than non-IPACK patients. Provenance and peer review Not commissioned externally peer reviewed.ĭata sharing statement All data relevant to the study are included in the article or uploaded as supplementary information.TL DR: Within a multimodal analgesic protocol, addition of IPACK blocks decreased the lowest pain scores on postoperative day (POD) 0, suggesting a role for new opioid-sparing analgesic techniques, and changing clinical practice change can occur rapidly.Ībstract: Background The Infiltration between the Popliteal Artery and Capsule of the Knee (IPACK) block is a new anesthesiologist- administered analgesic technique for controlling posterior knee pain that has not yet been well studied in total knee arthroplasty (TKA) patients. Patient consent for publication Not required.Įthics approval This cadaveric study was approved by the University of Toronto Health Sciences Research Ethics Board (No 27210). SKS has received honorarium from Pacira Pharmaceutical and Flexion Therapeutics. PP received equipment support from SonoSite Fujifilm Canada. ![]() VC has received honorarium from Aspen Pharma, BBraun, Smiths Medical and SonoSite. SKS contributed to the experimental design and drafting of the manuscript.įunding This research received no specific grant from any funding agency in the public, commercial or not-for-profit sectors.Ĭompeting interests AA: Anatomy Faculty, Allergan Academy of Excellence. LGA contributed to acquisition, analysis of data and drafting of the manuscript. Presented at This work has been previously presented in part at the 2018 World Congress on Regional Anesthesia and Pain Medicine, 19-21 April 2018, New York, NY, USA.Ĭontributors JT, PP, AA, and VC contributed to the experimental design, data acquisition, data analysis, drafting and revising the manuscript critically for important intellectual content. ![]()
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