Adductor Canal Block and iPACK Pain Control in Total Knee Replacement

Is this trial a fit for you?

A plain-English reading of the study's rules. Only the study team can confirm whether you qualify.

What this trial studies

In adults undergoing elective total knee arthroplasty, the study compares three analgesia strategies using ultrasound-guided ACB and iPACK blocks with 0.2% ropivacaine: standard blocks, blocks plus intravenous dexamethasone, and blocks with intravenous dexamethasone plus perineural dexmedetomidine. All patients receive spinal anesthesia and ropivacaine for blocks. The primary outcome is total opioid consumption in the first 48 hours postoperatively; secondary outcomes include pain scores, duration of analgesia, time to first rescue analgesia, and quadriceps strength. The trial aims to optimize postoperative analgesia while supporting early mobilization and reducing opioid-related side effects. The investigation builds on prior evidence that dexamethasone and dexmedetomidine can prolong analgesia, exploring their combined effects in this regional anesthesia approach.

Why it matters

Who can join: the full rules

Inclusion Criteria:

* Age between 60 and 100 years
* Scheduled for elective primary unilateral total knee arthroplasty
* American Society of Anesthesiologists (ASA) physical status I-III
* Ability to understand study procedures and provide written informed consent
* Eligibility for spinal anesthesia and ultrasound-guided regional anesthesia according to institutional standards

Exclusion Criteria:

* Known allergy or hypersensitivity to ropivacaine, dexamethasone, dexmedetomidine, or any study-related medication
* Contraindications to spinal anesthesia or peripheral nerve blocks
* Coagulation disorders or anticoagulant therapy preventing safe regional anesthesia
* Infection at the planned puncture site or systemic infection
* Severe neurological disorders affecting lower limb sensory or motor function
* Severe hepatic, renal, or uncontrolled cardiovascular disease
* Clinically significant bradycardia or advanced atrioventricular conduction abnormalities
* Chronic opioid use for more than 3 months before surgery
* Uncontrolled diabetes mellitus or contraindications to dexamethasone administration
* Inability or refusal to provide written informed consent

Where it's running

• The John Paul II Catholic University of Lublin
  Lublin, Poland Recruiting
• Poznan University of Medical Sciences
  Poznan, Poland Recruiting

Study contacts

• Study coordinator: Malgorzata Reysner, MD PhD
• Email: mreysner@ump.edu.pl
• Phone: +48 61 8310122

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How to take part

1. Review the eligibility criteria above with your treating physician.
2. Check the official listing on ClinicalTrials.gov for the latest contact details and recruitment status.
3. Contact the study coordinator or principal investigator to ask for pre-screening. Pre-screening is free and never obligates you to enroll.