iPACK-based multimodal analgesic regimen

The iPACK-based multimodal analgesic regimen is a clinical protocol developed by the University Health Network (UHN) in Toronto to manage postoperative pain and reduce opioid consumption following total knee arthroplasty (TKA). This multimodal approach integrates regional anesthesia techniques with systemic non-opioid medications to provide synergistic pain relief. The regional components include an Adductor Canal Block (ACB) and an iPACK (Infiltration between the Popliteal Artery and the posterior Capsule of the Knee) block, both of which utilize local anesthetics to target specific sensory nerves around the knee. Systemic administration involves intraoperative intravenous dexmedetomidine (an alpha-2 adrenergic agonist) and ketamine (an NMDA receptor antagonist) for sedation and analgesia, followed by postoperative intravenous dexamethasone (a corticosteroid) to mitigate inflammation and enhance recovery.

Other names

IPACK and multi-modal analgesic regimenOpioid Sparing Analgesic Strategies for TKA regimeniPACK block regimen