12/27/2023 0 Comments Cpt code for ipack injection![]() To compensate for this, SACB is usually combined with sciatic nerve block or multimodal drug periarticular injection (PAI). 4 However, the anteromedial part of the knee could be covered by SACB while the posterior knee pain still troubles patients. 6 Single-shot ACB (SACB) has shown efficacy in pain control. 1, 5 ACB can be administered as single or as continuous form (administered in the form of repeated boluses at specific predetermined intervals). The adductor canal block (ACB) is a widely accepted motor-sparing ultrasound-guided modality and could provide a blockade of the saphenous nerve and vastus medialis nerve with greater preservation of the quadriceps muscle strength than the femoral nerve block (FNB). 1- 3 Effective analgesia is of paramount importance for post-TKA patients because it could decrease pain scores, facilitate recovery, and reduce the rates of immobility-related complications. 1 The rate of patients who experienced moderate to severe postoperative pain was reported from 23% to 54%. Total knee arthroplasty (TKA) is regarded as an effective treatment that provides pain relief, deformity correction, and function reconstruction for patients with end-stage knee arthritis. Additional high-quality studies are required to further address this topic. With the iPACK added to SACB, pain scores, morphine consumption, functional ability were improved. No difference was found in clinical outcomes or complications. ![]() The iPACK + SACB group is also superior to the SACB group regarding function ability, which included range of motion (ROM) ( p = 0.001), time up to go (TUG) test ( p = 0.030), and ambulation distance ( p < 0.0001). Analysis demonstrated greater reduction in morphine consumption ( p = 0.007) in the iPACK + SACB group. When comparing the pain scores of subgroups analyzed at specific periods, lower scores in subgroups within 12 h (at rest and ambulation) and after 48 h (at ambulation) were observed in the iPACK + SACB group. Pooled data indicated lower pain scores at ambulation ( p < 0.0001) for iPACK + SACB. The follow-up periods ranged from 2 days to 3 months. Seven RCTs (304 knees in iPACK + SACB group 305 knees in SACB group) were included. The primary outcome was ambulation pain and secondary outcomes were rest pain, opioid consumption, function ability, clinical outcomes, and complications. Meta-analysis was performed with STATA 13.0 software, the risk ratios (RR) and mean differences (MD) were used to compare dichotomous and continuous variables. The included studies were assessed by two reviewers according to the Cochrane risk of bias criteria. Randomized controlled trials (RCTs) comparing patients receiving iPACK plus SACB with patients receiving SACB after TKA were included. PubMed, Ovid, Cochrane Library, and other databases were searched from the inception to January 2021. To evaluate the combination of the infiltration between the popliteal artery and the posterior capsule of the knee (iPACK) block and single adductor canal block (SACB) versus SACB for motor-sparing knee analgesia effects after total knee arthroplasty (TKA).
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