Delayed foot drop after a combination of the adductor canal block and IPACK block following total knee arthroplasty

• Published in: Journal of clinical anesthesia 2021-10, Vol.73, p.110363-110363, Article 110363
• Main Authors: Sreckovic, Svetlana D., Tulic, Goran D.Z., Jokanovic, Maja N., Dabetic, Uros D.J., Kadija, Marko V.
• Format: Article
• Language: English
• Subjects: Adductor canal block; Anesthesia; Foot drop; IPACK block; Joint replacement surgery; Joint surgery; Pain management; Postoperative analgesia; Postoperative period; Rehabilitation; Total knee artroplasty; Ultrasonic imaging
• ISSN: 0952-8180; 1873-4529
• DOI: 10.1016/j.jclinane.2021.110363

The АCB and IPACK block were administered in the post-anesthesia care unit under high-frequency ultrasound guidance (BK Medical ultrasound, flex focus 400) as a part of the post-TKA multimodal analgesia regimen. The midportion of the adductor canal beneath the sartorius muscle was identified using a linear probe of 10–12 MHz, followed by the injection of 15 mL of 0.33% levobupivacaine (10 mL of 0.5% levobupivacaine and 5 mL of 0.9% sodium chloride) into the canal, lateral to femoral artery, using a 22-gauge 50-mm echogenic needle (Stimuplex® insulated B Braun, Medical Germany) (Fig. 1). The patient was discharged home on the third day.2 Discussion The increase in the frequency of conduct of TKA worldwide has resulted in the formulation of different treatment strategies that aim to provide adequate pain management and early rehabilitation in the immediate postoperative period [1].