ACB and IPACK Block vs ACB Alone for Pain and Opioid Use After ACL Reconstruction with BTB Autograft .
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Postoperative Pain and Opioid Usage With Combined Adductor Canal and IPACK Block Versus Isolated Adductor Canal Block After Anterior Cruciate Ligament Reconstruction With a Bone-Patellar Tendon-Bone Autograft: A Single-Center Randomized Controlled Trial.
Am J Sports Med . 2025 May;53(6):1359-1367.Ninety-six patients undergoing anterior cruciate ligament reconstruction (ACLR) with a bone–patellar tendon–bone (BTB) autograft were randomized to receive either an adductor canal block alone (n=47) or a combination of adductor canal and IPACK block (n=49). The primary outcome was opioid consumption at 24 hours postoperatively. Secondary outcomes included opioid use at days 2, 3, and 7; visual analog scale (VAS) pain scores; patient satisfaction with pain control; and postanesthesia care unit (PACU) time. Outcomes were assessed at postoperative days (POD) 1, 2, 3, and 7. Overall, the results of the study revealed significantly lower opioid use and pain scores on POD 1–3 in the combined block group, along with higher satisfaction on POD 1. No differences were observed by POD 7. These findings suggest that the addition of an IPACK block provides improved early postoperative pain control and reduces opioid consumption after ACLR with a BTB autograft.
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