iPACK versus BiFeS posterior knee blocks combined with an adductor canal block for knee replacement recovery
Effects of iPACK and Biceps Femoris Short Head (BiFeS) Blocks Combined With Adductor Canal Block on Quality of Recovery After Total Knee Arthroplasty: A Prospective, Randomized, Double-Blind Clinical Trial
We will test whether adding an iPACK block or a BiFeS block to an adductor canal block improves pain relief and recovery for adults having a single-sided total knee replacement.
Quick facts
| Phase | Not applicable |
|---|---|
| Study type | Interventional |
| Enrollment | 74 (estimated) |
| Ages | 18 Years to 75 Years |
| Sex | All |
| Sponsor | Ataturk University Academic / other |
| Locations | 1 site (Erzurum) |
| Trial ID | NCT07248072 on ClinicalTrials.gov |
What this trial studies
This is a prospective, randomized, double-blind, parallel-group, single-center trial comparing two posterior knee analgesia techniques (iPACK and BiFeS) when given alongside an adductor canal block in elective unilateral total knee arthroplasty. Participants are adults scheduled for primary unilateral TKA under planned spinal anesthesia and will be randomized to receive one of the posterior blocks in addition to standard ACB. The trial measures postoperative recovery outcomes including pain scores, opioid consumption, quadriceps strength, early mobilization, and overall quality of recovery. The goal is to determine whether the newer BiFeS approach provides equal or better posterior knee analgesia with less motor involvement than the commonly used iPACK block.
Who should consider this trial
Good fit: Adults aged 18–75 years scheduled for elective primary unilateral total knee arthroplasty under planned spinal anesthesia with ASA physical status I–III who can provide informed consent are ideal candidates.
Not a fit: Patients with coagulation disorders or on anticoagulants, known allergy to local anesthetics, pre-existing neuromuscular disorders, active infection at the block site, pregnancy, or a history of neuropathic pain are unlikely to benefit or are excluded.
Why it matters
Potential benefit: If successful, this could improve postoperative pain control, speed early mobilization, and increase patient satisfaction after total knee replacement.
How similar studies have performed: The iPACK block is widely used with supporting clinical data for posterior knee analgesia, while the BiFeS block is newer with promising cadaveric and early clinical reports but limited head-to-head comparative trials.
Eligibility criteria
Show full inclusion / exclusion criteria
Inclusion Criteria: * Age 18-75 years * Scheduled for elective primary unilateral total knee arthroplasty (TKA) * Planned spinal anesthesia * ASA physical status I-III * Ability to understand study procedures and provide written informed consent Exclusion Criteria: * Known allergy or hypersensitivity to local anesthetics or other study medications * Coagulopathy or current anticoagulant therapy * Severe hepatic, renal, or cardiac failure * History of neuropathic pain * Infection at the site of proposed nerve block * Pre-existing neuromuscular disorders in the lower extremities * Inability to cooperate or refusal to participate in the study * Pregnancy
Where this trial is running
Erzurum
- Ataturk University — Erzurum, Turkey (Türkiye) (Recruiting)
Study contacts
- Principal investigator: Ahmet Murat Yayık, Principal Investigator — Ataturk University Department of Anesthesiology and Reanimation
- Study coordinator: Ahmet Murat Yayık, Associate Professor
- Email: m_yayik@hotmail.com
- Phone: +90-554-425-92-87
How to participate
- Review the eligibility criteria above with your treating physician.
- Visit the official trial page on ClinicalTrials.gov for the most current contact information and recruitment status.
- Contact the listed study coordinator or principal investigator to request pre-screening. Pre-screening is free and never obligates you to enroll.