EVALUATION OF POST-OPERATIVE ANALGESIC EFFICACY OF LOCAL INFILTRATION ANALGESIA IN PATIENTS UNDERGOING TOTAL KNEE ARTHROPLASTY -A PROSPECTIVE RANDOMIZED STUDY

Introduction – Total knee arthroplasty is considered as one of the most painful procedures in field of orthopedic surgery. In this study we intended to evaluate the analgesic efficacy of Local Infiltration Analgesia (LIA) with post-surgical single shot of adductor canal block in terms of good post-operative analgesia and early post- operative mobilization thus allowing faster rehabilitation and recovery and thereby improving the final outcome of TKA in long term. Material and method- A total of 60 patients were enrolled, 30 in each group. Group A received Standard General anesthesia & postoperative analgesia with a single shot of adductor canal block with 20cc of 0.25% ropivacaine along with intraoperative local infiltration analgesia. Group B also received Standard General anesthesia & postoperative analgesia with a single shot of adductor canal block with 20cc of 0.25% ropivacaine but intraoperative local infiltration analgesia was not administered in group B. Result- Group B patients required a greater number of rescue analgesic doses in comparison to Group A patients. The majority of the patients in Group A had early postoperative mobilization in comparison to Group B (p=0.003). Mean preoperative and 6-week postoperative WOMAC scores showed that difference was statistically significant (p=0.034), showing a significantly lower 6-week postoperative WOMAC score in Group A in comparison to Group B. Conclusion – Our study gives us a conclusion that intraoperative Local Infiltration Analgesia along with single shot of adductor canal block provides better post-operative pain relief & allows early mobilization of the patient thus enhancing the rehabilitation thereby improving the final outcome of the Total Knee Arthroplasty.

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Comparing adductor canal block with local infiltration analgesia in total knee arthroplasty: A prospective, blinded and randomized clinical trial

Journal of Clinical Anesthesia ◽

10.1016/j.jclinane.2018.01.014 ◽

2018 ◽

Vol 46 ◽

pp. 39-43 ◽

Cited By ~ 21

Author(s):

Qian Jun Tong ◽

Yean Chin Lim ◽

Huae Min Tham

Keyword(s):

Clinical Trial ◽

Total Knee Arthroplasty ◽

Randomized Clinical Trial ◽

Knee Arthroplasty ◽

Adductor Canal Block ◽

Local Infiltration Analgesia ◽

Local Infiltration ◽

Adductor Canal ◽

Total Knee ◽

Infiltration Analgesia

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Adductor canal block combined with local infiltration analgesia versus isolated adductor canal block in reducing pain and opioid consumption after total knee arthroplasty: a systematic review and meta-analysis

Journal of International Medical Research ◽

10.1177/0300060520926075 ◽

2020 ◽

Vol 48 (8) ◽

pp. 030006052092607

Author(s):

Jianyong Lv ◽

Cuiyuan Huang ◽

Zuofeng Wang ◽

Shan Ou

Keyword(s):

Total Knee Arthroplasty ◽

Meta Analysis ◽

Outcome Data ◽

Opioid Consumption ◽

Adductor Canal Block ◽

Local Infiltration Analgesia ◽

Local Infiltration ◽

Adductor Canal ◽

Total Knee ◽

Infiltration Analgesia

Objective To evaluate the efficacy and safety of the addition of local infiltration analgesia (LIA) to adductor canal block (ACB) for pain control after primary total knee arthroplasty (TKA). Methods Two reviewers independently searched for potentially relevant published studies using electronic databases, including PubMed® (1966 to June 2019), Embase® (1974 to June 2019) and Web of Science (1990 to June 2019). The results were pooled using the random-effects model to produce standard mean differences for continuous outcome data and odds ratio for categorical outcome data. Results A total of three randomized controlled trials (RCTs) and three non-RCTs were included for data extraction and meta-analysis. There were significant differences between the two groups regarding the postoperative pain score on postoperative day (POD) 0 and POD 1. The cumulative opioid consumption in the ACB plus LIA groups was significantly lower than that in the ACB groups on POD 0 and POD 1. No significant differences were found in terms of postoperative range of motion or length of hospitalization. Conclusion ACB plus LIA significantly reduced the postoperative pain score on POD 0 and POD 1 compared with isolated ACB. In addition, ACB plus LIA was associated with a significant reduction in opioid consumption during the early postoperative period.

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COMPARISON OF POSTOPERATIVE ANALGESIC EFFICACY OF POST SURGICAL SINGLE SHOT OF ADDUCTOR CANAL BLOCK VERSUS CONTINUOUS EPIDURALANALGESIA IN PATIENTS UNDERGOING TOTAL KNEE ARTHROPLASTY -A PROSPECTIVE RANDOMIZED CONTROL STUDY

10.36106/ijar/7801946 ◽

2020 ◽

pp. 1-4

Author(s):

Surya Prakash Garg ◽

Palash Gupta ◽

Nandini Bhatt ◽

Prashant Pandey

Keyword(s):

Total Knee Arthroplasty ◽

Muscle Strength ◽

Epidural Analgesia ◽

Single Shot ◽

Adductor Canal Block ◽

Adductor Canal ◽

Continuous Epidural Analgesia ◽

Group A ◽

Total Knee ◽

Group B

Introduction – Total knee arthroplasty is one of the most painful procedures. In this study we intended to compare two analgesic modalities i.e. single shot of Adductor canal block & Continuous epidural analgesia in terms of good post-operative analgesia, minimal motor involvement, good post-operative muscle strength thus allowing faster rehabilitation and recovery thereby improving the final outcome of TKR in long term. Material and method- A total of 60 patients were enrolled, 30 in each group. Group A received Standard General anesthesia & postoperative analgesia with a single shot of adductor canal block with 20cc of 0.25% ropivacaine. Group B received Combined spinal-epidural block & postoperative analgesia was maintained on continuous epidural infusion in the form of a mixture of 0.125% ropivacaine & fentanyl(2microgram/cc) at the rate of 6ml/hour. Result- Group B patients required a greater number of rescue analgesic doses in comparison to Group A patients. The majority of the patients in Group A had early postoperative mobilization in comparison to Group B (p=0.003). Mean preoperative and 6-week postoperative WOMAC scores showed that difference was statistically significant (p=0.034), showing a significantly lower 6-week postoperative WOMAC score in Group A in comparison to Group B. Conclusion – Our study gives us a conclusion that the post-surgical Single Shot of the adductor canal block is a better post-operative analgesic modality when compared with continuous epidural analgesia post-surgically in terms of better pain relief, good post-operative muscle strength, early mobilization of the patient, higher patient acceptability.

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