IPACK and genicular nerves block: which nerves are we targeting?

Sebastian, Maria Paz; Dsouza, Supriya; Uriarte, Olatz Aranburu

doi:10.1136/rapm-2021-103105

Cited by 2 publications

(2 citation statements)

References 5 publications

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“…In a previous cadaveric study, it showed that iPACK anesthetizes the knee articular branches from the common peroneal nerve, tibial nerve and the posterior branch of the obturator nerve, with the exception of the nerve to vastus lateralis (NVL), the nerve to vastus medialis and the lateral branch of the nerve of vastus intermedius (NVI). The PRF-iPACK would have resulted in the blockade of the posterior knee articular nerve branch, thus has potentially ensured the analgesia effect to relieve the posterior knee pain [ 12 , 13 ].…”

Section: Discussionmentioning

confidence: 99%

Pulsed radiofrequency of iPACK (interspace between the popliteal artery and the posterior knee capsule) for pain control following meniscus repair - A case report

Deviandri,

Pramana KH,

Yuliana

et al. 2024

Trauma Case Reports

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Section: Discussionmentioning

confidence: 99%

Pulsed radiofrequency of iPACK (interspace between the popliteal artery and the posterior knee capsule) for pain control following meniscus repair - A case report

Deviandri,

Pramana KH,

Yuliana

et al. 2024

Trauma Case Reports

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“…Although other authors propose that an increase in volume may result in an increased spread [ 20 ], further research exploring optimal concentration, dose and volume to provide effective coverage in a paediatric population is required. While this study focused on a neonatal sample, there are no foreseeable reasons why this block will not be appropriate for various paediatric age groups if the correct dosage and volume are applied.…”

Section: Discussionmentioning

confidence: 99%

A cadaveric study investigating the spread of injectate following an interspace between the popliteal artery and the capsule of the posterior knee block in a neonatal sample: a pilot study

Govender-Davies,

Davies,

Pillay-Addinall

2024

Anat Cell Biol

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The infiltration of the interspace between the popliteal artery and the capsule of the posterior knee (IPACK) block, is a novel ultrasound-guided technique used for postoperative pain management of the knee. The success of the block is attributed to the spread of injectate between the capsule of the knee and the popliteal artery. This novel technique is believed to target the articular branches of the tibial, common fibular (peroneal) and obturator nerves. However, the extent of the spread in a paediatric population is unknown. Therefore, this study aims to evaluate the spread of the IPACK block. Using ultrasound guidance, the IPACK block was replicated bilaterally in neonatal cadavers. Methylene blue dye (0.3 ml/kg) was injected proximally and distally. Subsequently, cadavers were dissected to determine the injectate spread. Proximal injections resulted in staining of some of the articular branches, while the distal injections resulted in staining of all four articular branches. Additional staining of the superior lateral and medial genicular nerves was noted irrespective of the technique. Overall, both injections resulted in posterior, anterolateral spread with limited medial spread. Results from this study reveal preservation of the main nerve trunks following the proximal technique, while the distal technique displayed greater staining of the articular branches. We believe that the block can be seen as a more holistic and viable alternative to lower limb blocks for the paediatric population, as it allows for a wider spread in the posterior and medial-lateral compartments of the knee.

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IPACK and genicular nerves block: which nerves are we targeting?

Cited by 2 publications

References 5 publications

Pulsed radiofrequency of iPACK (interspace between the popliteal artery and the posterior knee capsule) for pain control following meniscus repair - A case report

Pulsed radiofrequency of iPACK (interspace between the popliteal artery and the posterior knee capsule) for pain control following meniscus repair - A case report

A cadaveric study investigating the spread of injectate following an interspace between the popliteal artery and the capsule of the posterior knee block in a neonatal sample: a pilot study

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