超声引导下腘动脉与膝关节后囊间隙神经阻滞联合收肌管神经阻滞在老年单膝关节置换术中的应用

doi:10.3969/j.issn.1003-9198.2026.03.013

Abstract

Abstract: Objective To evaluate the application effect of ultrasound-guided infiltration between the popliteal artery and capsule of the posterior knee (IPACK) combined with adductor canal block (ACB) in the elderly patients undergoing unilateral total knee arthroplasty (TKA). Methods A total of 118 elderly patients who underwent unilateral TKA from May 2023 to May 2025 were selected as the research subjects. They were randomly divided into the observation group and the control group using a random number table method, with 59 cases in each group. The control group received ultrasound-guided proximal ACB, while the observation group received IPACK on the basis of the control group. The anesthesia time, number of postoperative analgesic pump presses, sufentanil dosage, and time to get out of bed were recorded. The visual analog scale (VAS) scores were evaluated 3, 12, 24, and 48 h after surgery. Serum levels of inflammatory factors, oxidative stress indicators, knee joint range of motion (ROM), and quadriceps muscle strength before surgery and 48 h after surgery were compared between the two groups. The occurrence of adverse reactions was also observed. Results Compared with the control group, the time to get out of bed in the observation group was shorter. The number of postoperative analgesic pump presses, sufentanil dosage, VAS score, levels of inflammatory factors and oxidative stress indicators were significantly lower, while the knee joint ROM and quadriceps muscle strength were significantly higher in the observation group compared with those in the control group (all P＜0.05). There was no statistically significant difference in the incidence rate postoperative adverse reactions between the two groups (11.9% vs 8.5%, P＞0.05). Conclusions Ultrasound-guided IPACK combined with ACB can provide better analgesic effect, milder inflammatory and oxidative stress responses, and better knee joint function recovery compared with single proximal ACB in the elderly patients undergoing unilateral TKA, without increasing adverse reactions.

Key words: total knee arthroplasty, popliteal artery and knee joint posterior capsule space nerve block, adductor canal block, knee joint range of motion, aged

CLC Number:

R 687.4

YIN Chunwei, XU Jun, DONG Peilong, QU Fangfang. Application of ultrasound-guided popliteal artery and knee joint posterior capsule space nerve block combined with adductor canal block in elderly patients undergoing unilateral total knee arthroplasty[J]. Practical Geriatrics, 2026, 40(3): 288-293.

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Application of ultrasound-guided popliteal artery and knee joint posterior capsule space nerve block combined with adductor canal block in elderly patients undergoing unilateral total knee arthroplasty

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