A randomised controlled trial comparing adductor canal block and femoral nerve block for knee arthroplasty.
- Author:
Yean Chin LIM
1
;
How Yow Kelvin QUEK
1
;
Wai Heng Jimmy PHOO
1
;
Chou Liang MAH
1
;
Shumei TAN
2
Author Information
- Publication Type:Journal Article
- Keywords: analgesia; nerve block; total knee arthroplasty
- MeSH: Aged; Aged, 80 and over; Analgesia, Patient-Controlled; methods; Analgesics, Opioid; therapeutic use; Anesthetics, Local; administration & dosage; Arthroplasty, Replacement, Knee; Double-Blind Method; Female; Femoral Nerve; Humans; Male; Middle Aged; Morphine; therapeutic use; Nerve Block; methods; Pain Management; methods; Pain Measurement; Pain, Postoperative; drug therapy; Prospective Studies; Quadriceps Muscle; drug effects; Treatment Outcome; Ultrasonography
- From:Singapore medical journal 2019;60(3):145-149
- CountrySingapore
- Language:English
-
Abstract:
INTRODUCTION:Adductor canal block (ACB) is hypothesised to provide superior analgesia to femoral nerve block (FNB) for total knee arthroplasty (TKA) while preserving quadriceps strength.
METHODS:30 patients undergoing TKA were randomised to receive either ACB or FNB. Baseline tests of quadriceps strength were performed. Ultrasound-guided blocks with 30 mL of 0.5% ropivacaine were administered before induction of general anaesthesia. Patient-controlled analgesia (morphine) was prescribed for postoperative analgesia. The primary outcome of this prospective, double-blinded, randomised controlled trial was morphine consumption (mean ± standard deviation) in the first 24 hours. Secondary outcomes were pain scores using a numeric rating scale (median and interquartile range [IQR]), quadriceps strength (% of baseline) and functional outcomes at 24 hours and 48 hours postoperatively.
RESULTS:There was no statistically significant difference in morphine consumption at 24 hours between the ACB and FNB groups (21 ± 11 mg vs. 20 ± 12 mg; p = 0.85). No statistically significant differences were observed between the ACB and FNB groups in pain scores at 24 hours (at rest: 0 [IQR 0-2] vs. 0 [IQR 0-2]; on movement: 5 [IQR 4-8] vs. 5 [IQR 3-8]) and quadriceps strength (24 hours: 28.8% ± 26.1% vs. 26.8% ± 19.6% of baseline; 48 hours: 31.5 ± 23.1% vs. 33.7% ± 20.1% of baseline). There were also no statistically significant differences in functional outcomes and length of stay.
CONCLUSION:We found no statistically significant differences in analgesic effects, quadriceps strength or functional recovery postoperatively between ACB and FNB.
