• Junsuke Nakase, Kengo Shimozaki, Kazuki Asai, Rikuto Yoshimizu, Mitsuhiro Kimura, and Hiroyuki Tsuchiya.
• Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kanazawa University, 13-1 Takaramachi, Kanazawa, 920-0934, Japan. nakase1007@yahoo.co.jp.
• Arch Orthop Trauma Surg. 2021 Jan 2.

IntroductionThe study aimed to compare the combination of femoral nerve block (FNB) with interspace between the popliteal artery and the capsule of posterior knee (IPACK) block (IPACK group) with the combination of FNB with lateral femoral cutaneous nerve (LFCN) block (LFCN group) for postoperative pain control in patients undergoing anterior cruciate ligament (ACL) reconstruction. We hypothesized that the lower pain scores and decreased suppository use would be noted in patients administered a combination of FNB and IPACK block.Materials And MethodsA non-randomized prospective controlled clinical trial was conducted. The IPACK and LFCN groups included 40 patients each. The patients received IPACK block and LFCN block alternately. Thirty minutes prior to the surgery and after administration of general anesthesia, patients received an ultrasound-guided FNB and IPACK block or LFCN block. After ACL reconstruction, the visual analog scale pain scores were recorded at 30 min, 4 h, 8 h, 12 h, 24 h, 48 h, and 72 h after the surgery. The administration and use of analgesic suppositories were assessed. These measures were compared among the treatment types at each time-point using the Welch's t-test.ResultsSuppository use was significantly less in the LFCN group than in the IPACK group. The pain scores were significantly lower in the LFCN group at 30 min, 4 h, 48 h, and 72 h after the surgery.ConclusionThe combination of FNB with LFCN block during ACL reconstruction significantly reduces pain in the early postoperative period compared to a combination of FNB with IPACK block.Level Of EvidenceProspective control trial, Level II.

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