Infiltration between popliteal artery and capsule of knee (iPACK) block
Synonyms
Injection between popliteal artery and capsule of knee block
Definitions
Nerve blockade of branches of sciatic nerve innervating posterior aspect of popliteal fossa
iPACK block targets articular branches of tibial, common peroneal, and obturator nerves in popliteal region
Selectively block innervation of posterior knee joint while sparing main trunks of tibial and common peroneal nerves to maintain sensorimotor function of lower leg
It is field block not targeting discrete nerve branches
iPACK block can be completed at 2 different levels
At level of 1 finger breadth above patella
At level of femoral condyle
PREPROCEDURE
Indications
Contraindications
Preprocedure Imaging
Getting Started
PROCEDURE
Patient Position/Location
Equipment Preparation
Procedure Steps
Findings and Reporting
Alternative Procedures/Therapies
POST PROCEDURE
Expected Outcome
Things To Do
Things To Avoid
OUTCOMES
Problems
Complications
Selected References
Gomez M et al:Ultrasound for Regional Anesthesia: iPACK block: advancing the science of ultrasound guided regional anesthesia and pain medicine. http://www.usra.ca/regional-anesthesia/specific-blocks/lower-limb/iPACK.php. Reviewed September 2019. Accessed September 10, 2019.
Kampitak W et al: Optimal location of local anesthetic injection into the interspace between the popliteal artery and posterior capsule of the knee (iPACK) for posterior knee pain after total knee arthroplasty: an anatomical and clinical study. Korean J Anesthesiol. 72(5):486-94, 2019
Niesen AD et al: Interspace between popliteal artery and posterior capsule of the knee (IPACK) injectate spread: a cadaver study. J Ultrasound Med. 38(3):741-5, 2019
Sebastian MP et al: Saphenous nerve and IPACK block. Reg Anesth Pain Med. ePub, 2019
Tran J et al: Evaluation of the iPACK block injectate spread: a cadaveric study. Reg Anesth Pain Med. ePub, 2019
Kim DH et al: Addition of infiltration between the popliteal artery and the capsule of the posterior knee and adductor canal block to periarticular injection enhances postoperative pain control in total knee arthroplasty: a randomized controlled trial. Anesth Analg. 129(2):526-35, 2018
Sankineani SR et al: Comparison of adductor canal block and IPACK block (interspace between the popliteal artery and the capsule of the posterior knee) with adductor canal block alone after total knee arthroplasty: a prospective control trial on pain and knee function in immediate postoperative period. Eur J Orthop Surg Traumatol. 28(7):1391-5, 2018
Soffin EM et al: Anesthesia and analgesia for total knee arthroplasty. Minerva Anestesiol. 84(12):1406-12, 2018
Thobhani S et al: Novel regional techniques for total knee arthroplasty promote reduced hospital length of stay: an analysis of 106 patients. Ochsner J. 17(3):233-8, 2017
Lages-Silva E et al: Effect of protective and non-protective antibodies in the phagocytosis rate of Trypanosoma cruzi blood forms by mouse peritoneal macrophages. Parasite Immunol. 9(1):21-30, 1987
Related Anatomy
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Related Differential Diagnoses
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References
Tables
Tables
KEY FACTS
Terminology
Procedure
Post Procedure
Outcomes
TERMINOLOGY
Abbreviations
Infiltration between popliteal artery and capsule of knee (iPACK) block
Synonyms
Injection between popliteal artery and capsule of knee block
Definitions
Nerve blockade of branches of sciatic nerve innervating posterior aspect of popliteal fossa
iPACK block targets articular branches of tibial, common peroneal, and obturator nerves in popliteal region
Selectively block innervation of posterior knee joint while sparing main trunks of tibial and common peroneal nerves to maintain sensorimotor function of lower leg
It is field block not targeting discrete nerve branches
iPACK block can be completed at 2 different levels
At level of 1 finger breadth above patella
At level of femoral condyle
PREPROCEDURE
Indications
Contraindications
Preprocedure Imaging
Getting Started
PROCEDURE
Patient Position/Location
Equipment Preparation
Procedure Steps
Findings and Reporting
Alternative Procedures/Therapies
POST PROCEDURE
Expected Outcome
Things To Do
Things To Avoid
OUTCOMES
Problems
Complications
Selected References
Gomez M et al:Ultrasound for Regional Anesthesia: iPACK block: advancing the science of ultrasound guided regional anesthesia and pain medicine. http://www.usra.ca/regional-anesthesia/specific-blocks/lower-limb/iPACK.php. Reviewed September 2019. Accessed September 10, 2019.
Kampitak W et al: Optimal location of local anesthetic injection into the interspace between the popliteal artery and posterior capsule of the knee (iPACK) for posterior knee pain after total knee arthroplasty: an anatomical and clinical study. Korean J Anesthesiol. 72(5):486-94, 2019
Niesen AD et al: Interspace between popliteal artery and posterior capsule of the knee (IPACK) injectate spread: a cadaver study. J Ultrasound Med. 38(3):741-5, 2019
Sebastian MP et al: Saphenous nerve and IPACK block. Reg Anesth Pain Med. ePub, 2019
Tran J et al: Evaluation of the iPACK block injectate spread: a cadaveric study. Reg Anesth Pain Med. ePub, 2019
Kim DH et al: Addition of infiltration between the popliteal artery and the capsule of the posterior knee and adductor canal block to periarticular injection enhances postoperative pain control in total knee arthroplasty: a randomized controlled trial. Anesth Analg. 129(2):526-35, 2018
Sankineani SR et al: Comparison of adductor canal block and IPACK block (interspace between the popliteal artery and the capsule of the posterior knee) with adductor canal block alone after total knee arthroplasty: a prospective control trial on pain and knee function in immediate postoperative period. Eur J Orthop Surg Traumatol. 28(7):1391-5, 2018
Soffin EM et al: Anesthesia and analgesia for total knee arthroplasty. Minerva Anestesiol. 84(12):1406-12, 2018
Thobhani S et al: Novel regional techniques for total knee arthroplasty promote reduced hospital length of stay: an analysis of 106 patients. Ochsner J. 17(3):233-8, 2017
Lages-Silva E et al: Effect of protective and non-protective antibodies in the phagocytosis rate of Trypanosoma cruzi blood forms by mouse peritoneal macrophages. Parasite Immunol. 9(1):21-30, 1987
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