Adding Peripheral Nerve Blocks to Injections Improves Knee Replacement Care

Adding peripheral nerve blocks to routine periarticular injections for total knee replacements has been linked to less postoperative pain and lower opioid consumption, according to a study that will be presented at the American Society of Regional Anesthesia (ASRA) and Pain Medicine meeting.

With increasing numbers of patients receiving total knee arthroplasty (TKA) in the outpatient setting, finding effective strategies to reduce postoperative pain are key. Many surgeons use periarticular injections (PAIs) for TKAs, but these injections are associated with loss of mobility and higher use of opioids, leading researchers to look for alternative analgesia methods.

David Kim, MD, Hospital for Special Surgery, New York , New York, and colleagues studied postoperative pain levels and opioid consumption in patients receiving PAIs compared with those receiving PAI plus motor-sparing peripheral nerve blocks (MSBs) — specifically adductor canal blocks and the interspace between the popliteal artery and capsule of the posterior knee (IPACK) block.

Results showed the patients receiving PAI plus MSB had significantly less pain and were more satisfied following surgery.

The 2018 World Congress on Regional Anesthesia and Pain Medicine will be held April 19 to 21 in New York City. The meeting brings together 5 intercontinental regional anaesthesia and pain medicine societies every 4 years.

The study, entitled The Addition of ACB and IPACK to PAI Enhances Postoperative Pain Control in TKA: a Randomized Controlled Trial, will be presented on April 21.