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NCT Number: NCT07700797

Adductor Canal Block With IPACK Versus 4-in-1 Block for Postoperative Analgesia in Knee Surgery

This randomized interventional study compares the analgesic efficacy of Adductor Canal Block combined with Infiltration of the Posterior Capsule of the Knee (IPCAK) versus the 4-in-1 block technique in patients undergoing knee surgery. Twenty-four patients were randomly allocated into two equal groups. The primary objective is to compare postoperative pain scores and analgesic requirements. Secondary outcomes include time to first rescue analgesia, total analgesic consumption, motor function preservation, and block-related complications.

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Key information

Conditions

Knee Surgeries Anterior Cruciate Ligament (ACL) Tear Lacerations Posterior Cruciate Ligament Tear Total Ankle Arthroplasty Wounds and Injuries

Age range

21 year–64 year

Sex eligibility

All sexes

Study type

Interventional

Phase

Not applicable

Primary location

Faculty of Medicine, Zagazig University Hospitals

Zagazig, Sharqia Province, 055, Egypt

About this study

Effective postoperative pain control following knee surgery is essential for early mobilization, rehabilitation, and patient satisfaction. Several regional anesthesia techniques have been developed to provide analgesia while preserving quadriceps muscle strength. Adductor Canal Block combined with Infiltration of the Posterior Capsule of the Knee (IPCAK) has been proposed as a motor-sparing technique that provides effective anterior and posterior knee analgesia. The 4-in-1 block is another ultrasound-guided regional anesthesia technique designed to provide comprehensive analgesia for knee surgery.

This prospective randomized interventional study enrolled 24 patients undergoing knee surgery. Participants were randomly assigned to receive either Adductor Canal Block with IPCAK or the 4-in-1 block. Postoperative pain scores, time to first rescue analgesia, total analgesic consumption, motor function, patient satisfaction, and complications were evaluated and compared between the two groups

Who can participate

Healthy volunteers accepted: Yes

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

  • 1. Patients or caregivers acceptance. 2. Age : 21 - 64 years 3. Sex : both ( males & females). 4. Physical status: ASA І & II. 5. BMI 18.5-30 kg/m2. 6. Type of operations : elective surgery. 7. Type of anesthesia: unilateral intrathecal anesthesia. 8. Patients undergoing elective knee surgery under unilateral spinal anesthesia 9. Duration of surgery within 2 hr.

Exclusion criteria

  • Known history of allergy to study drug Coagulopathies or taking drugs affecting coagulation.. Contraindications for peripheral nerve block (PNB) and spinal anesthesia (SA) (coagulation defects, infection at the puncture site), bone degenerative disease and posttraumatic condition of the spine, dementia and severe visual or auditory disorder.

Current severe psychiatric disease, alcoholism or drug dependence. Subjects with history previous knee surgery, osteoarthritis, malformation or tumors (including Baker's cyst), which could alter the normal anatomy of the popliteal fossa

Treatment and study plan

Adductor canal block with IPACK

Procedure

Ultrasound-guided Adductor Canal Block combined with IPCAK block

4 in 1 block

Procedure

Ultrasound-guided 4-in-1 block technique.

Primary outcomes

  1. Postoperative pain intensity measured by Visual Analog Scale (VAS)

    Time frame: 24 hours after surgery

    Postoperative pain will be assessed using the Visual Analog Scale (VAS) at rest and during movement at predetermined postoperative time points

Secondary outcomes

  1. Total opioid consumption

    Time frame: First 24 hours after surgery

    Total rescue opioid analgesic consumption during the first 24 postoperative hours

  2. Time to first rescue analgesia

    Time frame: Within 24 hours after surgery

    Time from completion of surgery to the first request for rescue analgesia

  3. Patient satisfaction with postoperative analgesia

    Time frame: 24 hours after surgery

    Patient satisfaction score regarding postoperative pain management

Sponsors and collaborators

Lead sponsor

Zagazig University

Other Gov

Registry information

Official study title

Effect of Adductor Canal Block With Infiltration of the Posterior Capsule of the Knee Versus 4-in-1 Block Technique for Postoperative Analgesia in Patients Undergoing Knee Surgeries

Important dates

Study start
2026
Primary completion
2026
Study completion
2026
First posted
Jul 14, 2026
Registry last updated
Jul 17, 2026

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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