Analgesic efficacy of adding the IPACK block to multimodal analgesia protocol for primary total knee arthroplasty: a meta-analysis of randomized controlled trials

Abstract

Key points Question Can IPACK as an additional analgesic method provide better results on postoperative knee pain and function recovery for patients after TKA? Findings Moderate evidence suggested that the addition of IPACK to themultimodal analgesia programs had better results on postoperative knee pain VAS scores, morphine usage, ambulation distances, muscle strength, and sleep disturbance without increasing the risk of complications, compared to those without IPACK. However, these differences in pain VAS scores, ambulation distances, and muscle strength were minor and had relative clinical significance. The reduced morphine consumption significantly confirmed the benefits of IPACK. Meaning The combinations of IPACK with other regional analgesia techniques (e.i. PAI, ACB) are recommended as an integral part of multimodal analgesia programs. More trials were needed to confirm the benefits of IPACK in different combinations.

Keywords

• IPACK block
• Total knee arthroplasty
• Randomized controlled trial
• Meta-analysis