There were significant differences between the patients in the ACB + iPACK Group and ACB Group on the TUG test of POD1 and POD2. The patients in the group of ACB + iPACK performed better in the postoperative range of knee movement (95%CI:, P < 0.00001) and walking distance (95%CI:, P < 0.00001). A differential was discovered to support the ACB + iPACK Group when comparing the two groups on postoperative cumulative morphine consumption (95%CI:, P: 0.0007). There are significant differences between the two groups in VAS score at rest and with activity, and the VAS scores were lower in the ACB + iPACK Group (VAS scores at rest: 95%CI, P < 0.00001. There are fourteen eligible studies for our meta-analysis. Trim-and-fill analysis was applied in terms of sensitivity analysis of the results. Publication bias was checked using Egger’s test. In addition, we performed GOSH analysis, subgroup analysis, meta-regression analysis to study the source of heterogeneity. Statistical analyses were conducted by Stata and RevMan Software. We searched in eight major databases for all clinical trials discussing the effect of two analgesia regimens after TKA. This paper compiles all available evidence on the effect of two analgesia regimens (ACB and iPACK + ACB) involving all sides. Several studies have suggested that the addition of iPACK block (the popliteal artery and the posterior knee capsule have been given interspace local anesthetic infiltration) might get better analgesia than adductor canal block (ACB) only after total knee arthroplasty (TKA).
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