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已发表论文
全膝关节置换术中脂质体布比卡因用于收肌管阻滞联合 IPACK 阻滞：一项前瞻性、双盲、随机对照试验
Authors Yuan Q , Shen W , He W , Wang X, Liu F , Zhang Y, Lu X, Guan Z , Zhang J, Yang L
Received 2 October 2025
Accepted for publication 9 January 2026
Published 14 January 2026 Volume 2026:20 566411
DOI https://doi.org/10.2147/DDDT.S566411
Checked for plagiarism Yes
Review by Single anonymous peer review
Peer reviewer comments 4
Editor who approved publication: Professor Yan Zhu
Qisong Yuan,1,* Wang Shen,1,* Wenbin He,2 Xiaomin Wang,2 Feng Liu,1 Yi Zhang,1 Xinge Lu,1 Zhaoming Guan,1 Jinyuan Zhang,3 Longqiu Yang1
1Department of Anesthesiology, Shanghai East Hospital, School of Medicine, Tongji University, Shanghai, People’s Republic of China; 2Department of Orthopedics, Shanghai East Hospital, School of Medicine, Tongji University, Shanghai, People’s Republic of China; 3Department of Pain, Shanghai East Hospital, School of Medicine, Tongji University, Shanghai, People’s Republic of China
*These authors contributed equally to this work
Correspondence: Longqiu Yang, Department of Anesthesiology, Shanghai East Hospital, School of Medicine, Tongji University, No. 150 Jimo Road, Pudong New District, Shanghai, 200120, People’s Republic of China, Email yanglongqiu2024@163.com
Purpose: Patients undergoing total knee arthroplasty (TKA) may experience severe postoperative pain despite preoperative nerve blocks. This study aims to investigate the effect of liposomal bupivacaine (LB) for adductor canal block (ACB) combined with infiltration between the popliteal artery and the posterior knee capsule (iPACK) in TKA.
Patients and Methods: This prospective, double-blind, randomized controlled trial was conducted from March 2025 to August 2025 in a Chinese tertiary hospital. 86 patients aged 18– 90 years, classified as the American Society of Anesthesiologists (ASA) Physical Status I–III and undergoing TKA, were randomly assigned to either the liposomal bupivacaine group (Group LB) or ropivacaine group (Group R). All patients underwent ACB combined with iPACK block administered with either LB or ropivacaine preoperatively. The primary outcome was visual analog scale (VAS) at multiple time points under three conditions: at rest, during maximum knee flexion, and during ambulation. Secondary outcomes included opioids consumption, knee range of motion (ROM), quadriceps strength, the Timed Up-and-Go (TUG) test within the first 3 days, as well as the American Knee Society (AKS) score and the Quality of Recovery-15 (QoR-15) score assessed at 2 weeks and 1 month.
Results: Demographic and baseline characteristics were comparable between groups (P> 0.05). The VAS scores in Group LB were significantly lower than those in Group R at 24h, 48h, and 72h across all assessment conditions (P< 0.05). However, these differences did not reach the minimal clinically important difference (MCID). From 48h to 72h, opioids consumption in Group LB was significantly lower than that in Group R (P< 0.05), but again not clinically significant. No significant differences were observed between groups in other outcomes (P> 0.05).
Conclusion: Liposomal Bupivacaine for adductor canal block combined with IPACK block provided no clinically significant benefit in patients undergoing total knee arthroplasty.
Keywords: liposomal bupivacaine, adductor canal block, iPACK block, total knee arthroplasty
1Department of Anesthesiology, Shanghai East Hospital, School of Medicine, Tongji University, Shanghai, People’s Republic of China; 2Department of Orthopedics, Shanghai East Hospital, School of Medicine, Tongji University, Shanghai, People’s Republic of China; 3Department of Pain, Shanghai East Hospital, School of Medicine, Tongji University, Shanghai, People’s Republic of China
*These authors contributed equally to this work
Correspondence: Longqiu Yang, Department of Anesthesiology, Shanghai East Hospital, School of Medicine, Tongji University, No. 150 Jimo Road, Pudong New District, Shanghai, 200120, People’s Republic of China, Email yanglongqiu2024@163.com
Purpose: Patients undergoing total knee arthroplasty (TKA) may experience severe postoperative pain despite preoperative nerve blocks. This study aims to investigate the effect of liposomal bupivacaine (LB) for adductor canal block (ACB) combined with infiltration between the popliteal artery and the posterior knee capsule (iPACK) in TKA.
Patients and Methods: This prospective, double-blind, randomized controlled trial was conducted from March 2025 to August 2025 in a Chinese tertiary hospital. 86 patients aged 18– 90 years, classified as the American Society of Anesthesiologists (ASA) Physical Status I–III and undergoing TKA, were randomly assigned to either the liposomal bupivacaine group (Group LB) or ropivacaine group (Group R). All patients underwent ACB combined with iPACK block administered with either LB or ropivacaine preoperatively. The primary outcome was visual analog scale (VAS) at multiple time points under three conditions: at rest, during maximum knee flexion, and during ambulation. Secondary outcomes included opioids consumption, knee range of motion (ROM), quadriceps strength, the Timed Up-and-Go (TUG) test within the first 3 days, as well as the American Knee Society (AKS) score and the Quality of Recovery-15 (QoR-15) score assessed at 2 weeks and 1 month.
Results: Demographic and baseline characteristics were comparable between groups (P> 0.05). The VAS scores in Group LB were significantly lower than those in Group R at 24h, 48h, and 72h across all assessment conditions (P< 0.05). However, these differences did not reach the minimal clinically important difference (MCID). From 48h to 72h, opioids consumption in Group LB was significantly lower than that in Group R (P< 0.05), but again not clinically significant. No significant differences were observed between groups in other outcomes (P> 0.05).
Conclusion: Liposomal Bupivacaine for adductor canal block combined with IPACK block provided no clinically significant benefit in patients undergoing total knee arthroplasty.
Keywords: liposomal bupivacaine, adductor canal block, iPACK block, total knee arthroplasty