Related Experiment Video
Updated: Mar 21, 2026

Author Spotlight: Minimally Invasive Ultrasound-Guided Acupotomy in Knee Osteoarthritis Treatment
Published on: April 26, 2024
Liposomal Bupivacaine for Adductor Canal Block Combined with IPACK Block in Total Knee Arthroplasty: A Prospective,
Qisong Yuan1, Wang Shen1, Wenbin He2
1Department of Anesthesiology, Shanghai East Hospital, School of Medicine, Tongji University, Shanghai, People's Republic of China.
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.
More Related Videos
Related Concept Videos
Local Anesthetics: Clinical Application as Intravenous Regional Anesthesia
One of the advantages of...
Local Anesthetics: Clinical Application as Spinal Anesthesia
Local Anesthetics: Clinical Application as Epidural Anesthesia
Since epidural anesthetics can be infused through an epidural catheter, all types of drugs, including short-acting ones, can be administered. Chloroprocaine and lidocaine are examples of short and long-duration anesthetics, respectively. Bupivacaine...
Local Anesthetics: Common Agents and Their Applications
Cocaine is an ester of benzoic acid and methylecgogine. It is used to anesthetize and vasoconstrict locally. Currently, it is used primarily for topical applications. It is beneficial for surgeries on the upper respiratory tract, providing anesthesia and shrinking the mucosa. Cocaine in the form of cocaine hydrochloride is...
Local Anesthetics: Clinical Application as Surface, Infiltration, and Conduction Block Anesthesia
Local Anesthetics: Pharmacokinetics

