One of the most popular treatments to address joint pain in individuals with advanced osteoarthritis or rheumatoid
arthritis of the knee is total knee arthroplasty (TKA). TKA, on the other hand, is followed by moderate to severe
postoperative pain, which has a negative impact on postoperative rehabilitation, patient satisfaction, and the overall
results of the procedure. Multimodal analgesia regimens including the Adductor Canal Block (ACB), Infiltration between
the Popliteal Artery and the Capsule of the Knee (IPACK) block, and a combination of these are routinely utilised to
provide safe early ambulation and rehabilitative activity. The purpose of this research was to assess and evaluate
postoperative analgesia following total knee arthroplasty between a combination low volume + Ipack block and a large
volume adductor canal block. A prospective, randomised, blind, and matched-pairs clinical trial was used for this study.
The institutional ethics committee at Benha University Hospital gave its assent to the study's protocol. There were two
groups of sixty patients each. Ultrasound-guided ACB with 20 mL of 0.125 bupivacaine was given to Group I:- Those in
this group got the procedure. For Group II, the ACB was performed utilising ultrasound guidance, along with 10 mL of
0.125 bupivacaine and one pack block. Results: The low volume adductor canal block with IPACK block had a lower
VAS score and lower opoid intake in the first 24 hours than the large volume adductor canal block, according to this
research. In the end, we propose the low volume ACB with IPACK block for postoperative pain after total knee
arthroplasty.