Effect of Adding Ultrasound Guided IPACK Block to Adductor Canal Block for Postoperative Pain in Knee Tumor Excision

NCT07382297 | Recruiting

• 1 other identifier: AP2407-201-011
• Study Type: interventional
• Target: 70
• Locations: 1 country
• Sites: 1

Brief Summary

the aim of this study is to determine the analgesic effect of iPACK in combination to ACB after the excision of tumors around the Knee regarding the following:

• Time to the 1st rescue analgesia.
• Postoperative morphine consumption.
• Postoperative visual analogue scale (VAS). This study will include patients, aged 18 to 65 years, belonging to the American Society of Anesthesiologists (ASA) physical status II to IV , undergoing excision of tumors around the knee under spinal anesthesia. Patients will be randomly allocated Group iPACK plus Adductor canal block (ACB) : patients will receive ACB plus iPACK block.
• Control group : patients will not receive any block but will take morphine 3mg bolus at VAS more than 4 and regular NSAIDS and paracetamol iv.

Conditions

Cancer Pain

Outcome Measures

Primary Outcomes (1)

• Time to the 1st rescue analgesia

  Time to the 1st rescue analgesia

  24 hours postoperative

Secondary Outcomes (2)

• Total morphine consumption

  first 24 hour

• pain score ( visual analogue scale)

  at 2 hours ,4 hours,6 hours, 12 hours,18 hours and 24 h postoperatively

Study Arms (2)

adductor canal block with iPACK

ACTIVE COMPARATOR

The adductor canal will be identified. a spinal needle 22 gauge x 3.5 inches will be advanced with the guidance of ultrasound in an in-plane technique, and 15ml of 0.5% bupivacaine will be injected then IPACK block will be performed The probe will be applied to the popliteal fossa for identification of the popliteal artery and femur. Then, the probe will be slid distally for revealing the two femoral condyles followed by proximal sliding of the probe until the humps of the femoral condyles disappeared and the flat metaphysis appeared. a spinal needle 22G x 3.5 inches will be advanced from the lateral aspect and directed across the space between the popliteal artery and femur and once the needle reaches the medial edge of the femur, nearly at the level of the popliteal artery, negative aspiration will be confirmed and 15ml of 0.5% bupivacaine will be injected incrementally as the needle will be withdrawn.

Procedure: adductor canal block with iPACK

control group

OTHER

visualizing the adductor canal without doing any block for the control group

Other: control group

Interventions

adductor canal block with iPACK PROCEDURE

The adductor canal will be identified. a spinal needle 22 gauge x 3.5 inches will be advanced with the guidance of ultrasound in an in-plane technique ,and 15ml of 0.5% bupivacaine will be injected then IPACK block will be performed. The probe will be applied to the popliteal fossa for identification of the popliteal artery and femur. Then, the probe will be slid distally for revealing the two femoral condyles followed by proximal sliding of the probe until the humps of the femoral condyles disappeared and the flat metaphysis appeared. a spinal needle 22G x 3.5 inches will be advanced from the lateral aspect and directed across the space between the popliteal artery and femur and once the needle reaches the medial edge of the femur, nearly at the level of the popliteal artery, negative aspiration will be confirmed and 15ml of 0.5% bupivacaine will be injected incrementally as the needle will be withdrawn

adductor canal block with iPACK

control group OTHER

The probe will be positioned at the midpoint between the anterior superior iliac spine and the upper pole of the patella. The adductor canal, which is a hyperechoic structure situated beneath the sartorius muscle, will be identified but no block will be done

control group

Eligibility Criteria

• Age: 18 Years - 65 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Stated willingness to comply with all study procedures and availability for the duration of the study
• American Society of Anesthesiologists (ASA) physical status II-IV.
• Patients undergoing excision of tumors around the knee under spinal anesthesia

You may not qualify if:

• Patient refusal.
• Neuromuscular disorders
• Allergy to local anesthetics
• Previous history of knee surgery
• Patients with a prior knee infection
• Contraindications to spinal anesthesia as coagulopathies and severe aortic stenosis.

Sponsors & Collaborators

• National Cancer Institute, Egypt: lead

Study Sites (1)

National cancer institute

Cairo, 11769, Egypt

RECRUITING

MeSH Terms

Conditions

Cancer Pain

Interventions

Control Groups

Condition Hierarchy (Ancestors)

Pain; Neurologic Manifestations; Signs and Symptoms; Pathological Conditions, Signs and Symptoms

Intervention Hierarchy (Ancestors)

Epidemiologic Research Design; Epidemiologic Methods; Investigative Techniques; Research Design; Methods

Study Officials

• Ghada Gamal Eldin Elsayed, MD

  National Cancer Institute (NCI)

  STUDY DIRECTOR

Central Study Contacts

Norma Osama Abdallah Zayed, MD

CONTACT

01067843111; norma.osama@nci.cu.edu.eg

Fady Attef, MSc

CONTACT

01224046183

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: DOUBLE
• Who Masked: PARTICIPANT, OUTCOMES ASSESSOR
• Purpose: PREVENTION
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: January 25, 2026
• First Posted: February 2, 2026
• Study Start: August 15, 2025
• Primary Completion (Estimated): May 30, 2026
• Study Completion (Estimated): June 30, 2026
• Last Updated: February 2, 2026

Record last verified: 2025-08

Data Sharing

• IPD Sharing: Will not share

Locations

EG (1)