Adductor Canal Block With Periarticular Injection and IPACK (ACB/PAI/IPACK) Versus Periarticular Injection (PAI) (IPACK)
Knee Arthropathy
About this trial
This is an interventional treatment trial for Knee Arthropathy focused on measuring IPACK, PAI
Eligibility Criteria
Inclusion Criteria:
- Patients with osteoarthritis scheduled for a primary either partial or total knee arthroplasty with a participating surgeon
- Age 18 to 80 years
- Planned use of regional anesthesia
- Ability to follow study protocol
- English speaking (secondary outcomes include questionnaires validated in English only)
- Patients of participating surgeons
Exclusion Criteria:
- Hepatic or renal insufficiency
- Younger than 18 years old and older than 80
- Patients undergoing general anesthesia
- Allergy or intolerance to one of the study medications
- BMI > 40
- Diabetes
- ASA of IV
- Chronic gabapentin/pregabalin use (regular use for longer than 3 months)
- Chronic opioid use (taking opioids for longer than 3 months, or daily oral morphine equivalent of >5mg/day for one month)
- Patients with severe valgus deformity and flexion contracture
Sites / Locations
- Hospital For Special SurgeryRecruiting
Arms of the Study
Arm 1
Arm 2
Active Comparator
Experimental
Peri-Articular Injections only
Peri-Articular Injections, Adductor Canal Block, and IPACK
Combined spinal epidural anesthetic with 1.5% Mepivacaine (60mg) Injection prior to cementation bupivacaine 0.5% with epinephrine 30cc; methylprednisolone, 40 mg/ml, 1 ml cefazolin, 500 mg in 10 ml normal saline, 22cc Superficial injection prior to closure. 20cc 0.25% bupivacaine 2 mg IV dexamethasone.
Combined spinal epidural anesthetic with 1.5% Mepivacaine (60mg) Injection prior to cementation bupivacaine 0.25% with epinephrine 30cc; methylprednisolone, 40 mg/ml, 1 ml cefazolin, 500 mg in 10 ml normal saline, 22cc Superficial injection prior to closure. a. 20cc 0.25% bupivacaine Adductor canal block technique (supine position, post IV sedation) a. Mid-thigh injection of 15 cc of bupivacaine 0.25% with 2 mg of PF Dexamethasone IPACK technique (supine position) a. 25 cc 0.25% bupivacaine