Table 3.
Summary of Postoperative Opioid Consumption in First 24 Hours
| Study | Summary of Result |
|---|---|
| Studies with Significant Association Favoring iPACK | |
| Kim 201913 | Patients receiving iPACK+ACB+mPAI had lower mean OME in PACU compared to control arm receiving PAI only (control 27.7±21.7 mg, iPACK 14.9±19.4 mg, p=0.005), but no differences of cumulative opioid consumption from 0–24 hours |
| Li 202030 | Patients receiving iPACK+ACB+PAI had lower mean OME in the first 24 hours compared to the control arm receiving ACB+PAI (control 16.00±7.82, iPACK 10.8±8.77, p<0.001) |
| Studies with Significant Association Not Favoring iPACK | |
| Kertkiatkachorn 202029 | Median cumulative IVME was higher in patients receiving iPACK+ACB+cACB compared to patients receiving cACB+PAI at 12 hours (0 [0–2] mg vs 0 [0–0] mg, p=0.004) and 24 hours postoperatively (2 [0–4] mg vs 0 [0–0] mg, p=0.002) |
| Tak 202028 | Mean cumulative OME at time of discharge was higher in patients receiving iPACK+ACB (31.110±5.649) as well as patients receiving ACB only (33.520±7.052) compared to patients receiving cACB only (30.110±5.257, p=0.011) |
| Studies with No Significant Association | |
| Kampitak 202025 | Median cumulative IVME was 2(2–2) for tibial group, 2(0–2) mg for proximal iPACK group, and 2(2–2) mg for distal iPACK group at both 12 hours and 24 hours postoperatively. No significant difference was detected for both comparisons |
| Patterson 202026 | There were no significant differences in median cumulative OME between the iPACK+cACB arm and control arm (cACB only) in PACU (control 23 [0–38] mg, iPACK 23 [15–29] mg, p=0.7928) and up to 24 hours (control 79 [58–123] mg, iPACK 90 [60–128] mg, p=0.7456) |
| Ochroch 202027 | There were no significant differences in mean cumulative OME between iPACK+cACB arm and control arm (cACB only) at 0–12 hours (control 30[15–45] mg, iPACK 30[15–45] mg, p=0.59) and at 12–24 hours postoperatively (control 15[7.5–30], iPACK 15[7.5–30], p=0.37) |
| Vichainarong 202031 | There were no significant differences in mean cumulative IVME between iPACK+cACB+PAI arm and control arm (cACB+PAI) at 12 hours (control 0.4±1 mg, iPACK 0.1±0.5 mg, p=0.11) and 24 hours postoperative (control 1.3±1.9, iPACK 0.6±1.3, p=0.08) |
Notes: Postoperative opioid consumption in PACU and up to 24 hours postoperatively are documented and presented in the table. When reported and available in study, mean (±standard deviation) and median (25%–75%ile interquartile range) were provided.
Abbreviations: IVME, IV morphine equivalents; OME, oral morphine equivalents; NRS, numerical rating scale; POD, postoperative day; FNC, femoral nerve catheter; ACB, adductor canal block; cACB, continuous adductor canal block; mPAI, modified arthroplasty block.