Infiltration Between the Popliteal Artery and Capsule of the Knee (iPACK): Essential Anatomy, Technique, and Literature Review
| Autor: | Ann-Marie Surette, Alexa Clement, Sanjay K. Sinha |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
Adductor canal
business.industry Femoral shaft Analgesic Capsule 030208 emergency & critical care medicine Anatomy medicine.disease Popliteal artery law.invention 03 medical and health sciences 0302 clinical medicine Anesthesiology and Pain Medicine medicine.anatomical_structure Randomized controlled trial 030202 anesthesiology law Cadaver medicine.artery medicine business Infiltration (medical) |
| Zdroj: | Current Anesthesiology Reports. 9:474-478 |
| ISSN: | 2167-6275 |
| Popis: | In this review, we discuss the essential iPACK (Infiltration between the Popliteal Artery and Capsule of the Knee) anatomy, block technique as well as potential complications, contraindications, and relevant literature evaluating the efficacy of the iPACK block. Recent literature supports the efficacy of the iPACK in controlling pain, improving postoperative physical therapy performance, and decreasing hospital length of stay (LOS). Cadaver studies have demonstrated that injection of dye in the tissue plane between the popliteal artery and the femoral shaft cranial to femoral condyles spreads to the genicular nerves that innervate the posterior knee and forms the basis of the analgesic mechanism of the iPACK. Randomized controlled trials have shown that the iPACK, when used in combination with a femoral nerve block (FNB) or adductor canal block (ACB), is superior to a FNB or ACB alone in controlling postoperative pain. The iPACK controls posterior knee pain following total knee arthroplasty (TKA) by anesthetizing the articular branches from the sciatic and obturator nerves. This is a safe and relatively simple block to perform with a low risk of serious complications. |
| Databáze: | OpenAIRE |
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