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Abstract K nee surgeries are needed in a wide range of patients, from young athletes with anterior cruciate ligament injuries up to old patients with comorbidities presenting for arthroscopy up to total knee replacement procedures. The trend is fast track knee surgery with early ambulation and hospital discharge, so analgesic options of neuraxial blocks and main nerve blocks are less attractive due to the unavoidable muscle weakness. In this study, the benefit of pure sensory nerve block could be reached. The study aims to assess the impact of combining ACB (adductor canal block) with IPACK (infiltration between the popliteal artery and capsule of the knee) compared to using ACB alone or IPACK alone in patients who have undergone unilateral knee arthroplasty, with a focus on postoperative pain management and mobility outcomes. Our study is a randomized, prospective, comparative study where 60 patients subjected to knee surgeries were randomized into two groups: group (A): patients in this group received ultrasound guided Adductor canal block only; group (B): under ultrasound guide, patients in this group received IPACK block at the start of surgery group (C): under ultrasound guide, patients in this group received a combined adductor canal block and IPACK block at the start of surgery. Our study revealed that regardless of the good analgesic effect of ACB, patients who received a combination of ACB and IPACK blocks have experienced a better pain control, a wider range of motion and a longer walking distance following surgery when compared to patients who received ACB alone or IPACK alone. Additionally, there was no statistically significant difference between groups in terms of opioid needs or consumption. |