To evaluate the effectiveness of Adductor Canal Block and combined Adductor Canal plus IPACK block in reducing postoperative pain and analgesic requirements in patients undergoing knee surgery.
ASA (American Society of Anesthesiologists) I- ASA II-ASA III Patients
history of allergy to the study medication
refusal to participate
Patients aged ≥18 years, classified as ASA physical status I-III, scheduled to undergo total knee arthroplasty.
Cohort
Other
Adductor Canal Block Group (Group I)
Procedure/SurgeryAll patients in Group I will receive a preoperative adductor canal block. In all groups, an intravenous patient-controlled analgesia device containing morphine will be administered for postoperative pain management.
Adductor Canal + iPACK Block Group (Group II)"
Procedure/SurgeryAll patients in Group II will receive a preoperative adductor canal block combined with an iPACK block. Postoperatively, all patients in both groups will be provided with intravenous patient-controlled analgesia containing morphine for pain management.
opioid consumption
In the recovery room, all patients will given a patient- controlled analgesia device containing morphine 0.5 mg/ml, set to deliver a 1mg bolus dose of morphine with an 15 min lockout time and 4 mg 1 h limit.Total morphine consumption during the 24 hours postoperative period will recorded at 5 times intervals ( 2, 4, 6, 12, 24 hours).
Verbal analog Pain Scores on rest and movement
A Research assistant, blinded to the group allocation, interviewed patients and collected data at 5 times intervals ( 2, 4, 6, 12, 24, hours) in the 24 hours postoperatively. Patients were asked to rate their pain using verbal analog scale, where 0= no pain and 10= worst pain possible.
incidences of adverse effects (like nausea and vomiting)
incidences of nausea and vomiting during the 24 hours postoperative period will recorded at 6 time intervals ( 2, 4, 6, 12, 24 hours).
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