| Content Provider | Springer Nature : BioMed Central |
|---|---|
| Author | Domagalska, MaĆgorzata Wieczorowska-Tobis, Katarzyna Reysner, Tomasz Kowalski, Grzegorz |
| Abstract | Introduction Total knee arthroplasty (TKA) is commonly performed in patients with end-stage osteoarthritis or rheumatoid arthritis of the knee to reduce joint pain, increase mobility, and improve quality of life. However, TKA is associated with moderate to severe postoperative pain, which remains a significant clinical challenge. Surgeon-administered PAI and anesthesiologist-administered iPACK have proven viable alternatives to conventional peripheral nerve blocks. This review aims to discuss which IPACK block or periarticular injection, combined or not with different peripheral nerve blocks, has better effects on postoperative rehabilitation, patient satisfaction, and overall outcome. Material and methods The literature review was performed on standards of care, current therapeutic options, a pain management protocol, and innovative treatment options for patients undergoing total knee arthroplasty. The literature was reviewed through four electronic databases: PubMed, Cochrane Library, Google Scholar, and Embase. Results The initial search yielded 694 articles. Fifty relevant articles were selected based on relevance, recentness, search quality, and citations. Six studies compared PAI to peripheral nerve block (PNB), and eight studies checked the effectiveness of adding PNB to PAI. Three studies compared iPACK to PNB, and ten reviewed the point of adding PNB to iPACK. Conclusions The literature review indicates that the best analgesic effect is obtained by combining PAI or iPACK with a peripheral nerve block, particularly with ACB, due to its analgesic, motor-sparing effect, and satisfactory analgesia. |
| Related Links | https://perioperativemedicinejournal.biomedcentral.com/counter/pdf/10.1186/s13741-023-00346-8.pdf |
| Ending Page | 17 |
| Page Count | 17 |
| Starting Page | 1 |
| File Format | HTM / HTML |
| ISSN | 20470525 |
| DOI | 10.1186/s13741-023-00346-8 |
| Journal | Perioperative Medicine |
| Issue Number | 1 |
| Volume Number | 12 |
| Language | English |
| Publisher | BioMed Central |
| Publisher Date | 2023-11-15 |
| Access Restriction | Open |
| Subject Keyword | Intensive Critical Care Medicine Emergency Medicine Surgery Human Physiology Multimodal analgesia Pain Local infiltration analgesia Adductor canal block Femoral nerve block Knee surgery |
| Content Type | Text |
| Resource Type | Review |
| Subject | Surgery |
| Journal Impact Factor | 2/2023 |
| 5-Year Journal Impact Factor | 2.6/2023 |
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