Comparison of Different Concentrations of Ropivacaine Used for Ultrasound-Guided Adductor Canal Block + IPACK Block in Total Knee Arthroplasty.

研究概要

Ninety patients with osteoarthritis undergoing primary unilateral total knee arthroplasty were randomized to receive an ultrasound-guided adductor canal block plus IPACK block with ropivacaine 0.2% (n=30), 0.25% (n=30), or 0.3% (n=30). The primary outcome of interest was the visual analog scale (VAS) pain score at rest 30 minutes after arriving in the PACU. Secondary outcomes included postoperative VAS pain scores at various timepoints, morphine consumption within 24 hours, time to first rescue analgesia, range of motion, quadriceps strength, and complication rates. Outcomes were assessed over 48 hours postoperatively. Overall, the results revealed that both 0.25% and 0.3% concentrations led to significantly lower early pain scores, reduced morphine use, delayed rescue analgesia, and better range of motion compared to 0.2%. These findings suggest that ropivacaine 0.25% and 0.3% offer more effective early analgesia without increased risk.