scholarly journals Adductor Canal Blocks in Total Knee Arthroplasty Do Not Always Mean Quadriceps Weakness Is Not a Problem: A Word of Caution

2021 ◽  
Vol 103 (1) ◽  
pp. e3
Author(s):  
Richard F. Kyle
2013 ◽  
Vol 58 (3) ◽  
pp. 362-364 ◽  
Author(s):  
CHRISTOPHER VEAL ◽  
DAVID B. AUYONG ◽  
NEIL A. HANSON ◽  
CINDY J. ALLEN ◽  
WYNDAM STRODTBECK

2020 ◽  
Vol 3 ◽  
Author(s):  
Macy Dimmett ◽  
Mary Ziemba-Davis ◽  
Leonard Buller ◽  
R. Michael Meneghini

Background and Hypothesis:  Adequate pain control and avoidance of falls are crucial for successful early recovery following total knee arthroplasty (TKA). Studies have shown an increase in postoperative quadriceps weakness (QW) and pain associated with tourniquet use during TKA. Additionally, increasing doses of adductor canal block (ACB) anesthetic per unit of BMI are associated with QW after TKA. This retrospective cohort study examined whether tourniquets and ACBs have a synergistic effect on postoperative QW and pain.     Experimental Design or Project Methods:  348 TKAs in 319 patients performed by a single surgeon between October 2015 and May 2018 were retrospectively reviewed. Outcomes included QW as documented in the physical therapy evaluation, average pain score during the first 24 hours after PACU discharge, average pain score during the remainder of the hospital stay, and final pain score prior to discharge.    Results:  Sex, age, and BMI did not differ in patients with ACBs with (n=177) and without (n=168) tourniquet use (p≥0.330). The overall prevalence of QW in the sample was 8.7%. Proportionally more patients with ACBs and tourniquets (11.6%) had QW compared to patients with ACBs without tourniquets (6.1%), but the difference was not statistically significant with the numbers available. Patient-reported pain scores at the three time points did not differ significantly between patients who received ACBs with or without tourniquets.     Conclusion and Potential Impact:  There appears to be no synergistic effect of ACBs and tourniquet use on postoperative pain. However, due to the effect size and number of cases in each group, the synergistic effect of ACBs and tourniquet use on QW deserves additional study with a larger sample size as these results may impact functional recovery and postoperative complications among patients undergoing primary TKA. 


2021 ◽  
Vol 12 ◽  
pp. 215145932199663
Author(s):  
Mustafa Kaçmaz ◽  
Zeynep Yüksel Turhan

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.


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