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The Future of Knee Repair - February 2016 - Outpatient Surgery Magazine

Outpatient Surgery Magazine, providing current information on Surgical Services, Surgical Facility Administration, Outpatient Surgery News and Trends, OR Excellence and more.

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1 5 2 • O U T PA T I E N T S U R G E R Y M A G A Z I N E • F E B R U A R Y 2 0 1 6 A New Nerve Block for Posterior Knee Pain The "iPACK" controls pain in the back of the knee after arthroplasty. T he problem spot for patients having total knee arthroplasty: the back of the knee. While region- al nerve blocks have revolution- ized pain control for total knees, until recently they've fallen short when it comes to easing pain in the back of the knee. Pain relief following knee replacement surgery has typi- cally been concentrated in the anteromedial aspects of the knee, with little relief for the posterior. Femoral nerve blocks cover the femoral nerve and adductor canal blocks cover the saphenous nerve. Blocking the sciatic nerve, which is what provides innervation to the posterior of the knee, is dangerous, because it may cause foot drop and thus mask a surgically induced peroneal nerve injury caused dur- ing surgery. Thankfully, a new regional technique with a catchy name has proven to effectively control posterior knee pain. Posterior pain I augment each of my blocks with an "iPACK" (infiltration between popliteal artery and capsule of knee) block and have seen a signifi- cant reduction in post-op posterior pain. Anesthesia Alert Mike MacKinnon, CRNA • PROBLEM SPOT Mr. MacKinnon places an "iPACK" block, which can decrease posterior knee pain without masking a peroneal nerve injury. Kirt Rosenlof, CRNA

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