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.
Effectiveness of continuous adductor canal block versus continuous epidural analgesia in patients with total knee arthroplasty: A systematic review
