Analgesic effect of continuous adductor canal block versus continuous femoral nerve block for knee arthroscopic surgery: a randomized trial

Abstract Background: The authors conducted a randomized, controlled, parallel-arm, superiority study to test the hypothesis that a continuous adductor canal block decreases the time to attain four discharge criteria compared with a continuous femoral nerve block after tricompartment knee arthroplasty. Methods: Subjects undergoing tricompartment knee arthroplasty were randomized using computer-generated lists to either an adductor canal or femoral perineural catheter (3-day ropivacaine 0.2% infusion) in an unmasked manner. The primary outcome was the time to attain four criteria: (1) adequate analgesia; (2) intravenous opioids independence; (3) ability to stand, walk 3 m, return, and sit down; and (4) ambulate 30 m. Results: Subjects with an adductor canal catheter (n = 39) reached all four criteria in a median of 55 h (interquartile, 42 to 63 h) compared with 61 h (49 to 69 h) for those with a femoral catheter (n = 41; 95% CI, −13 to 1 h; P = 0.12). The percentage of subjects who reached the two mobilization criteria on postoperative days 1 and 2 were 72 and 95% for those with an adductor canal catheter (n = 39), but only 27 and 76% in subjects with a femoral catheter (n = 41; both P < 0.001). Differences in pain scores at rest and intravenous opioid requirements were minimal, but femoral infusion improved dynamic analgesia (P = 0.01 to 0.02). Conclusion: Compared with a continuous femoral nerve block, a continuous adductor canal block did not appreciably decrease the time to overall discharge readiness even though it did decrease the time until adequate mobilization, primarily because both groups experienced similar analgesia and intravenous opioid requirements that—in most cases—exceeded the time to mobilization.

Download Full-text

Effectiveness of continuous adductor canal block versus continuous femoral nerve block in patients with total knee arthroplasty

Medicine ◽

10.1097/md.0000000000018056 ◽

2019 ◽

Vol 98 (48) ◽

pp. e18056 ◽

Cited By ~ 7

Author(s):

Zhen Zhang ◽

Yu Wang ◽

Yuanyuan Liu

Keyword(s):

Total Knee Arthroplasty ◽

Nerve Block ◽

Knee Arthroplasty ◽

Femoral Nerve Block ◽

Femoral Nerve ◽

Adductor Canal Block ◽

Adductor Canal ◽

Continuous Femoral Nerve Block ◽

Total Knee

Download Full-text

Continuous femoral nerve block is more effective than continuous adductor canal block for treating pain after total knee arthroplasty

Medicine ◽

10.1097/md.0000000000017358 ◽

2019 ◽

Vol 98 (39) ◽

pp. e17358 ◽

Cited By ~ 6

Author(s):

Michał Borys ◽

Michał Domagała ◽

Krzysztof Wencław ◽

Joanna Jarczyńska-Domagała ◽

Mirosław Czuczwar

Keyword(s):

Total Knee Arthroplasty ◽

Nerve Block ◽

Knee Arthroplasty ◽

Femoral Nerve Block ◽

Femoral Nerve ◽

Adductor Canal Block ◽

Adductor Canal ◽

Continuous Femoral Nerve Block ◽

Total Knee

Download Full-text

Faculty Opinions recommendation of Adductor canal block versus femoral nerve block for analgesia after total knee arthroplasty: a randomized, double-blind study.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.718141133.793486509 ◽

2013 ◽

Author(s):

Stephan Schug

Keyword(s):

Total Knee Arthroplasty ◽

Nerve Block ◽

Knee Arthroplasty ◽

Femoral Nerve Block ◽

Femoral Nerve ◽

Double Blind Study ◽

Adductor Canal Block ◽

Double Blind ◽

Adductor Canal ◽

Total Knee

Download Full-text

The Effect of Femoral Nerve Block and Adductor Canal Block Methods on Patient Satisfaction in Unilateral Knee Arthroplasty: Randomized Non-Inferiority Trial

Geriatric Orthopaedic Surgery & Rehabilitation ◽

10.1177/2151459321996632 ◽

2021 ◽

Vol 12 ◽

pp. 215145932199663

Author(s):

Mustafa Kaçmaz ◽

Zeynep Yüksel Turhan

Keyword(s):

Total Knee Arthroplasty ◽

Patient Satisfaction ◽

Nerve Block ◽

Knee Arthroplasty ◽

Femoral Nerve Block ◽

Femoral Nerve ◽

Adductor Canal Block ◽

Adductor Canal ◽

Significant Difference ◽

Total Knee

Introduction: Femoral Nerve Block (FNB) and Adductor Canal Block (ACB) methods, which are regional analgesic techniques, are successfully used in postoperative pain control after total knee arthroplasty. This study aimed to compare adductor canal block method that was preoperatively used and femoral nerve block method in total knee arthroplasty (TKA) patients who underwent spinal anesthesia in terms of factors effecting patient satisfaction and determine whether these methods were equally effective or not. Methods: A total of 80 patients between the ages of 60 and 75 who were in the American Society of Anesthesia (ASA) physical status of I-III were prospectively included in this randomized study. Patients (n = 40) who received FNB were called Group FNB and patients (n = 40) who received Adductor Canal Block were called Group ACB. Results: Although mean postoperative VAS values were lower in FNB group only in the first hour (p = 0.02) there was no significant difference between the groups in the third, fifth, seventh, ninth, 12th and 24th hours (p≥0.05). Although Bromage scores were lower in FNB group in the first, second, third, fourth and fifth hours there was no statistically significant difference between the groups (p≥0.05). When mobilization time, patient satisfaction level, time of first analgesia, intraoperative sedation need, and recovery time of sensorial block were compared no statistically significant difference was found (p≥0.05). Discussion: When ACB and FNB that are used for postoperative analgesia in patients who undergo total knee arthroplasty are compared in terms of factors affecting patient satisfaction it is observed that they result in the same level (non-inferiority) of patient satisfaction. Conclusion: We recommend the routine use of ACB method with FNB in total knee arthroplasty. More studies focusing especially on measuring patient satisfaction are needed.

Download Full-text