ACB and iPACK Blocks With Intravenous Dexamethasone and Perineural Dexmedetomidine in Total Knee Arthroplasty
Key facts
- Where
- Lublin and Poznan, PolandSee the 2 sites
Could this be for you?
Answer for yourself. This is not a decision: only the study team can say whether you can take part.
- Are you between 60 and 100 years old?
Source: NCT07677215, who can take part
Where in Poland
- The John Paul II Catholic University of LublinLublin, PolandContact: Michał Borys, MD PhDTaking people
- Poznan University of Medical SciencesPoznan, PolandContact: Malgorzata Reysner, M.D. Ph.D.Taking people
Questions to ask the study team
- How often do I need to come in, and for how long each time?
- Are travel costs paid?
- Can I keep my own doctor?
- What happens if I want to stop?
Contact the study team: see the registry record → Contacts and Locations
Print a page for my doctorTrial details
- Who runs it
- Poznan University of Medical Sciences
- Trial code
- NCT07677215
- Record updated
- 5 November 2026
- Original description
This prospective randomized controlled trial aims to compare the analgesic efficacy and safety of three adjuvant strategies for ultrasound-guided Adductor Canal Block (ACB) and iPACK block in patients undergoing elective total knee arthroplasty under spinal anesthesia. All participants will receive standardized spinal anesthesia with 0.5% ropivacaine combined with ACB and iPACK blocks using 0.2% ropivacaine. Patients will be randomized into one of three groups: standard ACB + iPACK without adjuvants, ACB + iPACK with intravenous dexamethasone 8 mg, or ACB + iPACK with intravenous dexamethasone 8 mg combined with perineural dexmedetomidine added to both regional blocks.Read full original descriptionShow less
Comparison of the Efficacy and Safety of Three Adjuvant Strategies for ACB and iPACK Blocks in Patients Undergoing Elective Total Knee Arthroplasty: A Prospective, Randomized Clinical Trial
This prospective randomized controlled trial aims to compare the analgesic efficacy and safety of three adjuvant strategies for ultrasound-guided Adductor Canal Block (ACB) and iPACK block in patients undergoing elective total knee arthroplasty under spinal anesthesia. All participants will receive standardized spinal anesthesia with 0.5% ropivacaine combined with ACB and iPACK blocks using 0.2% ropivacaine. Patients will be randomized into one of three groups: standard ACB + iPACK without adjuvants, ACB + iPACK with intravenous dexamethasone 8 mg, or ACB + iPACK with intravenous dexamethasone 8 mg combined with perineural dexmedetomidine added to both regional blocks.
The primary outcome will be total postoperative opioid consumption during the first 48 hours after surgery expressed as intravenous morphine equivalents. Secondary outcomes will include pain intensity at rest and during movement, duration of analgesia, time to first rescue analgesia, quadriceps muscle strength, early mobilization, adverse events, inflammatory markers, and length of hospital stay.
Inclusion: 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: Chronic opioid use for more than 3 months before surgery; Known allergy or hypersensitivity to ropivacaine, dexamethasone, dexmedetomidine, or any study-related medication; 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; Uncontrolled diabetes mellitus or contraindications to dexamethasone administration; Contraindications to spinal anesthesia or peripheral nerve blocks; Clinically significant bradycardia or advanced atrioventricular conduction abnormalities; Inability or refusal to provide written informed consent.