Back to resultsiPACK Block for Total Knee Arthroplasty
Primary Purpose
Knee Osteoarthritis, Knee Pain Chronic, Knee Disease
Status
Active
Phase
Phase 4
Locations
Poland
Study Type
Interventional
Intervention
Ropivacaine 0.5% Injectable Solution 20mL
0,9% normal saline 20mL
Sponsored by
About this trial
This is an interventional treatment trial for Knee Osteoarthritis focused on measuring iPACK block, regional anesthesia, multimodal analgesia, total knee arthroplasty
Eligibility Criteria
Inclusion Criteria: Patients > 18 years old undergoing unilateral total knee arthroplasty Exclusion Criteria: refusal to participate < 18 yo Chronic opioid use localized infection
Sites / Locations
- Poznan University of Medical Sciences
Arms of the Study
Arm 1
Arm 2
Arm Type
Experimental
Experimental
Arm Label
preop iPACK block
preop placebo block
Arm Description
Patients will receive a preoperative ultrasound-guided Interspace between the Popliteal Artery and Capsule of the Posterior Knee (iPACK) block with 20 mL 0.5% ropivacaine. Using appropriate sterile precautions, and procedural sedation with up to 2 mg IV midazolam, an ultrasound (Mindray TE9) equipped with either a linear 15-6 megahertz (MHz), or a curvilinear 5-2 MHz transducer (habitus-dependent) used to identify the distal femoral shaft and popliteal artery. After spinal anesthesia, a 22g 80 mm echogenic block needle (Stimuplex Ultra 360) is advanced lateral to medial, in-plane, from the anteromedial aspect of the knee, toward the space between the popliteal artery and femur. 20 mL 0.5% ropivacaine is injected into the space between the popliteal artery and femur. The needle is withdrawn, and the needle entry site is wiped clean.
Patients will receive a preoperative ultrasound-guided Interspace between the Popliteal Artery and Capsule of the Posterior Knee (iPACK) block with 20 mL 0.5% ropivacaine. Using appropriate sterile precautions, and procedural sedation with up to 2 mg IV midazolam, an ultrasound (Mindray TE9) equipped with either a linear 15-6 megahertz (MHz), or a curvilinear 5-2 MHz transducer (habitus-dependent) used to identify the distal femoral shaft and popliteal artery. After spinal anesthesia, a 22g 80 mm echogenic block needle (Stimuplex Ultra 360) is advanced lateral to medial, in-plane, from the anteromedial aspect of the knee, toward the space between the popliteal artery and femur. 20 mL 0.9% normal saline is injected into the space between the popliteal artery and femur. The needle is withdrawn, and the needle entry site is wiped clean.
Outcomes
Primary Outcome Measures
Numerical Rating Scale [Range from 0:no pain to 10:the worst pain]
Numerical Rating Scale [Range from 0:no pain to 10:the worst pain]
Numerical Rating Scale [Range from 0:no pain to 10:the worst pain]
NRS (numerical rating scale from 0- no pain to 10- the worst pain)
Numerical Rating Scale [Range from 0:no pain to 10:the worst pain]
NRS (numerical rating scale from 0- no pain to 10- the worst pain)
Numerical Rating Scale [Range from 0:no pain to 10:the worst pain]
NRS (numerical rating scale from 0- no pain to 10- the worst pain)
Opioid consumption 24 hours postoperatively
intravenous morphine equivalents (mg)
Opioid consumption 48 hours postoperatively
intravenous morphine equivalents (mg)
Opioid consumption 72 hours postoperatively
intravenous morphine equivalents (mg)
Opioid consumption >72 hours postoperatively
intravenous morphine equivalents (mg)
Time to first opioid administration
hours
Secondary Outcome Measures
Rehabilitation process Verticalization by the balcony
Verticalization by the balcony (binary outcome yes or no)
Rehabilitation process Verticalization by the balcony
Verticalization by the balcony (binary outcome yes or no)
Rehabilitation process Verticalization by the balcony
Verticalization by the balcony (binary outcome yes or no)
Rehabilitation process Verticalization with help
Verticalization- with help (yes/no)
Rehabilitation process Verticalization with help
Verticalization- with help (yes/no)
Rehabilitation process Verticalization with help 5th day
Verticalization- with help (yes/no)
Rehabilitation process Verticalization - impossible 1st day
Verticalization- impossible (yes/no)
Rehabilitation process Verticalization - impossible 2nd day
Verticalization- impossible (yes/no)
Rehabilitation process Verticalization - impossible 5th day
Verticalization- impossible (yes/no)
Rehabilitation process Walking distance- unlimited with crutches 1st day
Walking distance- unlimited with crutches (yes/no)
Rehabilitation process Walking distance- unlimited with crutches 2nd day
Walking distance- unlimited with crutches (yes/no)
Rehabilitation process Walking distance- unlimited with crutches 5th day
Walking distance- unlimited with crutches (yes/no)
Rehabilitation process Walking distance- by the balcony 1st day
Walking distance- by the balcony (yes/no)
Rehabilitation process Walking distance- by the balcony 2nd day
Walking distance- by the balcony (yes/no)
Rehabilitation process Walking distance- by the balcony 5th day
Walking distance- by the balcony (yes/no)
Rehabilitation process Walking distance- impossible- bed bound 1st day
Walking distance- impossible- bed bound (yes/no)
Rehabilitation process Walking distance- impossible- bed bound 2nd day
Walking distance- impossible- bed bound (yes/no)
Rehabilitation process - getting out of bed- no problems 1st day
getting out of bed with no problems (yes/no)
Rehabilitation process - getting out of bed- no problems 2nd day
getting out of bed with no problems (yes/no)
Rehabilitation process - getting out of bed- no problems 5th day
getting out of bed with no problems (yes/no)
Rehabilitation process - getting out of bed- with help 1st day
getting out of bed with help (yes/no)
Rehabilitation process - getting out of bed- with help 2nd day
getting out of bed with help (yes/no)
Rehabilitation process - getting out of bed- with help 5th day
getting out of bed with help (yes/no)
Rehabilitation process - getting out of bed- with assistance 1st day
getting out of bed with assistance (yes/no)
Rehabilitation process - getting out of bed- with assistance 2nd day
getting out of bed with assistance (yes/no)
Rehabilitation process - getting out of bed- with assistance 5th day
getting out of bed with assistance (yes/no)
Rehabilitation process - RANGE OF MOTION - CONTRACTURE IN THE KNEE JOINT - full extension- 1st day
CONTRACTURE IN THE KNEE JOINT - full extension (yes/no)
Rehabilitation process - RANGE OF MOTION - CONTRACTURE IN THE KNEE JOINT - full extension- 2nd day
CONTRACTURE IN THE KNEE JOINT - full extension (yes/no)
Rehabilitation process - RANGE OF MOTION - CONTRACTURE IN THE KNEE JOINT - full extension- 5th day
CONTRACTURE IN THE KNEE JOINT - full extension (yes/no)
Rehabilitation process - RANGE OF MOTION - flexion contracture IN THE KNEE JOINT - full extension- 1st day
flexion contracture IN THE KNEE JOINT (yes/no)
Rehabilitation process - RANGE OF MOTION - flexion contracture IN THE KNEE JOINT - full extension- 2nd day
flexion contracture IN THE KNEE JOINT (yes/no)
Rehabilitation process - RANGE OF MOTION - flexion contracture IN THE KNEE JOINT - full extension- 5th day
flexion contracture IN THE KNEE JOINT (yes/no)
Rehabilitation process - bending range of motion- passive movement to 45 degrees- no pain- 1st day
bending range of motion- passive movement to 45 degrees with no pain- (yes/no)
Rehabilitation process - bending range of motion- passive movement to 45 degrees- with pain- 1st day
bending range of motion- passive movement to 45 degrees with pain- (yes/no)
Rehabilitation process - bending range of motion- passive movement to 45 degrees- no pain- 2nd day
bending range of motion- passive movement to 45 degrees with no pain- (yes/no)
Rehabilitation process - bending range of motion- passive movement to 45 degrees- with pain- 2nd day
bending range of motion- passive movement to 45 degrees with pain- (yes/no)
Rehabilitation process - bending range of motion- passive movement to 45 degrees- no pain- 5th day
bending range of motion- passive movement to 45 degrees with no pain- (yes/no)
Rehabilitation process - bending range of motion- passive movement to 45 degrees- with pain- 5th day
bending range of motion- passive movement to 45 degrees with pain- (yes/no)
Rehabilitation process - bending range of motion- active movement to 90 degrees- no pain- 5th day
bending range of motion- active movement to 90 degrees with no pain- (yes/no)
Rehabilitation process - bending range of motion- active movement to 90 degrees- no pain- 2nd day
bending range of motion- active movement to 90 degrees with no pain- (yes/no)
Rehabilitation process - bending range of motion- active movement to 90 degrees- no pain- 1st day
bending range of motion- active movement to 90 degrees with no pain- (yes/no)
Rehabilitation process - bending range of motion- active movement to 90 degrees- with pain- 1st day
bending range of motion- active movement to 90 degrees with pain- (yes/no)
Rehabilitation process - bending range of motion- active movement to 90 degrees- with pain- 2nd day
bending range of motion- active movement to 90 degrees with pain- (yes/no)
Rehabilitation process - bending range of motion- active movement to 90 degrees- with pain- 5th day
bending range of motion- active movement to 90 degrees with pain- (yes/no)
Full Information
NCT ID
NCT06087562
First Posted
February 19, 2023
Last Updated
October 11, 2023
Sponsor
Poznan University of Medical Sciences
1. Study Identification
Unique Protocol Identification Number
NCT06087562
Brief Title
iPACK Block for Total Knee Arthroplasty
Official Title
Interspace Between the Popliteal Artery and Capsule of the Posterior Knee (iPACK) Block for Postoperative Rehabilitation in Total Knee Arthroplasty: a Randomized Control Trial
Study Type
Interventional
2. Study Status
Record Verification Date
October 2023
Overall Recruitment Status
Active, not recruiting
Study Start Date
June 16, 2020 (Actual)
Primary Completion Date
September 30, 2024 (Anticipated)
Study Completion Date
December 30, 2024 (Anticipated)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Poznan University of Medical Sciences
4. Oversight
Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
No
5. Study Description
Brief Summary
This randomized, double-blinded, placebo-controlled trial seeks to evaluate the efficacy of the rehabilitation process of the Interspace between the Popliteal Artery and Capsule of the Posterior Knee (iPACK) block in total knee arthroplasty.
Detailed Description
The Interspace between the Popliteal Artery and Capsule of the Posterior Knee (iPACK) block, has been recently described and shows promise in providing analgesia to the knee joint. The effect of this block on postoperative rehabilitation is uncertain. This study aims to compare a preoperative iPACK block to a placebo block prior to total knee arthroplasty under spinal anesthesia. The primary outcome measure is verticalization, walking distance, ability to go out of bed, active lifting of the limb, range of motion in the hip joint, bending range of motion, and abduction range of motion. The secondary measure is postoperative pain assessment during rehabilitation.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Knee Osteoarthritis, Knee Pain Chronic, Knee Disease
Keywords
iPACK block, regional anesthesia, multimodal analgesia, total knee arthroplasty
7. Study Design
Primary Purpose
Treatment
Study Phase
Phase 4
Interventional Study Model
Parallel Assignment
Model Description
Randomized, triple-blind, placebo-controlled
Masking
ParticipantCare ProviderInvestigator
Masking Description
Subjects will be randomized to one of two groups with a computer-generated arm assignment. The sealed envelopes will be opened immediately before the nerve block. One group will receive an iPACK block, and the other will receive a placebo block. The provider performing the league will not be blinded. However, all other care team members, the patient, and the investigator collecting data will be blinded to randomization.
Allocation
Randomized
Enrollment
350 (Anticipated)
8. Arms, Groups, and Interventions
Arm Title
preop iPACK block
Arm Type
Experimental
Arm Description
Patients will receive a preoperative ultrasound-guided Interspace between the Popliteal Artery and Capsule of the Posterior Knee (iPACK) block with 20 mL 0.5% ropivacaine. Using appropriate sterile precautions, and procedural sedation with up to 2 mg IV midazolam, an ultrasound (Mindray TE9) equipped with either a linear 15-6 megahertz (MHz), or a curvilinear 5-2 MHz transducer (habitus-dependent) used to identify the distal femoral shaft and popliteal artery. After spinal anesthesia, a 22g 80 mm echogenic block needle (Stimuplex Ultra 360) is advanced lateral to medial, in-plane, from the anteromedial aspect of the knee, toward the space between the popliteal artery and femur. 20 mL 0.5% ropivacaine is injected into the space between the popliteal artery and femur. The needle is withdrawn, and the needle entry site is wiped clean.
Arm Title
preop placebo block
Arm Type
Experimental
Arm Description
Patients will receive a preoperative ultrasound-guided Interspace between the Popliteal Artery and Capsule of the Posterior Knee (iPACK) block with 20 mL 0.5% ropivacaine. Using appropriate sterile precautions, and procedural sedation with up to 2 mg IV midazolam, an ultrasound (Mindray TE9) equipped with either a linear 15-6 megahertz (MHz), or a curvilinear 5-2 MHz transducer (habitus-dependent) used to identify the distal femoral shaft and popliteal artery. After spinal anesthesia, a 22g 80 mm echogenic block needle (Stimuplex Ultra 360) is advanced lateral to medial, in-plane, from the anteromedial aspect of the knee, toward the space between the popliteal artery and femur. 20 mL 0.9% normal saline is injected into the space between the popliteal artery and femur. The needle is withdrawn, and the needle entry site is wiped clean.
Intervention Type
Drug
Intervention Name(s)
Ropivacaine 0.5% Injectable Solution 20mL
Other Intervention Name(s)
Ropimol
Intervention Description
Ultrasound-guided iPACK block with 20mL of 0,5% ropivacaine
Intervention Type
Drug
Intervention Name(s)
0,9% normal saline 20mL
Other Intervention Name(s)
placebo
Intervention Description
Ultrasound-guided placebo block with 20mL of 0,9% normal saline
Primary Outcome Measure Information:
Title
Numerical Rating Scale [Range from 0:no pain to 10:the worst pain]
Description
Numerical Rating Scale [Range from 0:no pain to 10:the worst pain]
Time Frame
within 24 hours postoperatively
Title
Numerical Rating Scale [Range from 0:no pain to 10:the worst pain]
Description
NRS (numerical rating scale from 0- no pain to 10- the worst pain)
Time Frame
1 st postoperative day
Title
Numerical Rating Scale [Range from 0:no pain to 10:the worst pain]
Description
NRS (numerical rating scale from 0- no pain to 10- the worst pain)
Time Frame
2nd postoperative day
Title
Numerical Rating Scale [Range from 0:no pain to 10:the worst pain]
Description
NRS (numerical rating scale from 0- no pain to 10- the worst pain)
Time Frame
5 th postoperative day
Title
Opioid consumption 24 hours postoperatively
Description
intravenous morphine equivalents (mg)
Time Frame
24 hours postoperatively
Title
Opioid consumption 48 hours postoperatively
Description
intravenous morphine equivalents (mg)
Time Frame
24-48 hours postoperatively
Title
Opioid consumption 72 hours postoperatively
Description
intravenous morphine equivalents (mg)
Time Frame
48-72 hours postoperatively
Title
Opioid consumption >72 hours postoperatively
Description
intravenous morphine equivalents (mg)
Time Frame
72-96 hours postoperatively
Title
Time to first opioid administration
Description
hours
Time Frame
0-12 hours postoperatively
Secondary Outcome Measure Information:
Title
Rehabilitation process Verticalization by the balcony
Description
Verticalization by the balcony (binary outcome yes or no)
Time Frame
1st postoperative day
Title
Rehabilitation process Verticalization by the balcony
Description
Verticalization by the balcony (binary outcome yes or no)
Time Frame
2nd postoperative day
Title
Rehabilitation process Verticalization by the balcony
Description
Verticalization by the balcony (binary outcome yes or no)
Time Frame
5th postoperative day
Title
Rehabilitation process Verticalization with help
Description
Verticalization- with help (yes/no)
Time Frame
1st postoperative day
Title
Rehabilitation process Verticalization with help
Description
Verticalization- with help (yes/no)
Time Frame
2nd postoperative day
Title
Rehabilitation process Verticalization with help 5th day
Description
Verticalization- with help (yes/no)
Time Frame
5th postoperative day
Title
Rehabilitation process Verticalization - impossible 1st day
Description
Verticalization- impossible (yes/no)
Time Frame
1st postoperative day
Title
Rehabilitation process Verticalization - impossible 2nd day
Description
Verticalization- impossible (yes/no)
Time Frame
2nd postoperative day
Title
Rehabilitation process Verticalization - impossible 5th day
Description
Verticalization- impossible (yes/no)
Time Frame
5th postoperative day
Title
Rehabilitation process Walking distance- unlimited with crutches 1st day
Description
Walking distance- unlimited with crutches (yes/no)
Time Frame
1st postoperative day
Title
Rehabilitation process Walking distance- unlimited with crutches 2nd day
Description
Walking distance- unlimited with crutches (yes/no)
Time Frame
2nd postoperative day
Title
Rehabilitation process Walking distance- unlimited with crutches 5th day
Description
Walking distance- unlimited with crutches (yes/no)
Time Frame
5th postoperative day
Title
Rehabilitation process Walking distance- by the balcony 1st day
Description
Walking distance- by the balcony (yes/no)
Time Frame
1st postoperative day
Title
Rehabilitation process Walking distance- by the balcony 2nd day
Description
Walking distance- by the balcony (yes/no)
Time Frame
2nd postoperative day
Title
Rehabilitation process Walking distance- by the balcony 5th day
Description
Walking distance- by the balcony (yes/no)
Time Frame
5th postoperative day
Title
Rehabilitation process Walking distance- impossible- bed bound 1st day
Description
Walking distance- impossible- bed bound (yes/no)
Time Frame
1st postoperative day
Title
Rehabilitation process Walking distance- impossible- bed bound 2nd day
Description
Walking distance- impossible- bed bound (yes/no)
Time Frame
2nd postoperative day
Title
Rehabilitation process - getting out of bed- no problems 1st day
Description
getting out of bed with no problems (yes/no)
Time Frame
1st postoperative day
Title
Rehabilitation process - getting out of bed- no problems 2nd day
Description
getting out of bed with no problems (yes/no)
Time Frame
2nd postoperative day
Title
Rehabilitation process - getting out of bed- no problems 5th day
Description
getting out of bed with no problems (yes/no)
Time Frame
5th postoperative day
Title
Rehabilitation process - getting out of bed- with help 1st day
Description
getting out of bed with help (yes/no)
Time Frame
1st postoperative day
Title
Rehabilitation process - getting out of bed- with help 2nd day
Description
getting out of bed with help (yes/no)
Time Frame
2nd postoperative day
Title
Rehabilitation process - getting out of bed- with help 5th day
Description
getting out of bed with help (yes/no)
Time Frame
5th postoperative day
Title
Rehabilitation process - getting out of bed- with assistance 1st day
Description
getting out of bed with assistance (yes/no)
Time Frame
1st postoperative day
Title
Rehabilitation process - getting out of bed- with assistance 2nd day
Description
getting out of bed with assistance (yes/no)
Time Frame
2nd postoperative day
Title
Rehabilitation process - getting out of bed- with assistance 5th day
Description
getting out of bed with assistance (yes/no)
Time Frame
5th postoperative day
Title
Rehabilitation process - RANGE OF MOTION - CONTRACTURE IN THE KNEE JOINT - full extension- 1st day
Description
CONTRACTURE IN THE KNEE JOINT - full extension (yes/no)
Time Frame
1st day postoperative day
Title
Rehabilitation process - RANGE OF MOTION - CONTRACTURE IN THE KNEE JOINT - full extension- 2nd day
Description
CONTRACTURE IN THE KNEE JOINT - full extension (yes/no)
Time Frame
2nd day postoperative day
Title
Rehabilitation process - RANGE OF MOTION - CONTRACTURE IN THE KNEE JOINT - full extension- 5th day
Description
CONTRACTURE IN THE KNEE JOINT - full extension (yes/no)
Time Frame
5th day postoperative day
Title
Rehabilitation process - RANGE OF MOTION - flexion contracture IN THE KNEE JOINT - full extension- 1st day
Description
flexion contracture IN THE KNEE JOINT (yes/no)
Time Frame
1st day postoperative day
Title
Rehabilitation process - RANGE OF MOTION - flexion contracture IN THE KNEE JOINT - full extension- 2nd day
Description
flexion contracture IN THE KNEE JOINT (yes/no)
Time Frame
2nd day postoperative day
Title
Rehabilitation process - RANGE OF MOTION - flexion contracture IN THE KNEE JOINT - full extension- 5th day
Description
flexion contracture IN THE KNEE JOINT (yes/no)
Time Frame
5th day postoperative day
Title
Rehabilitation process - bending range of motion- passive movement to 45 degrees- no pain- 1st day
Description
bending range of motion- passive movement to 45 degrees with no pain- (yes/no)
Time Frame
1st day postoperative day
Title
Rehabilitation process - bending range of motion- passive movement to 45 degrees- with pain- 1st day
Description
bending range of motion- passive movement to 45 degrees with pain- (yes/no)
Time Frame
1st day postoperative day
Title
Rehabilitation process - bending range of motion- passive movement to 45 degrees- no pain- 2nd day
Description
bending range of motion- passive movement to 45 degrees with no pain- (yes/no)
Time Frame
2nd day postoperative day
Title
Rehabilitation process - bending range of motion- passive movement to 45 degrees- with pain- 2nd day
Description
bending range of motion- passive movement to 45 degrees with pain- (yes/no)
Time Frame
2nd day postoperative day
Title
Rehabilitation process - bending range of motion- passive movement to 45 degrees- no pain- 5th day
Description
bending range of motion- passive movement to 45 degrees with no pain- (yes/no)
Time Frame
5th day postoperative day
Title
Rehabilitation process - bending range of motion- passive movement to 45 degrees- with pain- 5th day
Description
bending range of motion- passive movement to 45 degrees with pain- (yes/no)
Time Frame
5th day postoperative day
Title
Rehabilitation process - bending range of motion- active movement to 90 degrees- no pain- 5th day
Description
bending range of motion- active movement to 90 degrees with no pain- (yes/no)
Time Frame
1st day postoperative day
Title
Rehabilitation process - bending range of motion- active movement to 90 degrees- no pain- 2nd day
Description
bending range of motion- active movement to 90 degrees with no pain- (yes/no)
Time Frame
2nd day postoperative day
Title
Rehabilitation process - bending range of motion- active movement to 90 degrees- no pain- 1st day
Description
bending range of motion- active movement to 90 degrees with no pain- (yes/no)
Time Frame
1st day postoperative day
Title
Rehabilitation process - bending range of motion- active movement to 90 degrees- with pain- 1st day
Description
bending range of motion- active movement to 90 degrees with pain- (yes/no)
Time Frame
1st day postoperative day
Title
Rehabilitation process - bending range of motion- active movement to 90 degrees- with pain- 2nd day
Description
bending range of motion- active movement to 90 degrees with pain- (yes/no)
Time Frame
2nd day postoperative day
Title
Rehabilitation process - bending range of motion- active movement to 90 degrees- with pain- 5th day
Description
bending range of motion- active movement to 90 degrees with pain- (yes/no)
Time Frame
5th day postoperative day
10. Eligibility
Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
100 Years
Accepts Healthy Volunteers
Accepts Healthy Volunteers
Eligibility Criteria
Inclusion Criteria:
Patients > 18 years old undergoing unilateral total knee arthroplasty
Exclusion Criteria:
refusal to participate
< 18 yo
Chronic opioid use
localized infection
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Małgorzata Domagalska, PhD
Organizational Affiliation
Department of Palliative Medicine, University of Medical Sciences, Poznań, Poland
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
Zbigniew Żaba, PhD
Organizational Affiliation
Department of Emergency Medicine
Official's Role
Study Chair
Facility Information:
Facility Name
Poznan University of Medical Sciences
City
Poznan
State/Province
Wielkopolska
ZIP/Postal Code
61-701
Country
Poland
12. IPD Sharing Statement
Plan to Share IPD
Yes
IPD Sharing Plan Description
The data presented in this study are available on request from the corresponding author.
IPD Sharing Time Frame
December 2024
IPD Sharing Access Criteria
The data presented in this study are available on request from the corresponding author.
Learn more about this trial
iPACK Block for Total Knee Arthroplasty
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