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Adductor Canal Block Versus Femoral Nerve Block for Postoperative Pain Management in Anterior Cruciate Ligament Reconstruction: A Prospective Interventional Study.

作者信息

Dhumey Tapan, Bhalerao Nikhil, Paul Amreesh, Wanjari Dnyanshree

机构信息

Anaesthesiology, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND.

出版信息

Cureus. 2024 Jul 15;16(7):e64625. doi: 10.7759/cureus.64625. eCollection 2024 Jul.


DOI:10.7759/cureus.64625
PMID:39149628
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11325116/
Abstract

Background A common knee joint disorder is injury to the anterior cruciate ligament (ACL), which often requires surgery. Proper pain control after the surgery facilitates fast recovery and prevents chronic pain. To provide analgesia for knee procedures, the use of opioids, non-steroidal anti-inflammatory medications, and regional techniques are commonly employed. This study aims to evaluate the efficacy of adductor canal block (ACB) and femoral nerve block (FNB) for postoperative pain management after anterior cruciate ligament reconstructions (ACLRs). Methodology This prospective interventional study included 30 participants scheduled for patellar graft ACLR. They were assigned into groups, i.e., ACB and FNB, with 15 patients each. The evaluation occurred one day before the operation, and all surgical procedures were performed using spinal anesthesia. During the postoperative period, a 10-point visual analog scale (VAS) was utilized to quantify pain intensity at the end of the surgery and at various intervals after the surgery. Patients with a VAS score greater than 4 received either FNB or ACB using bupivacaine 0.125%. Duration of analgesia time, power of quadriceps muscle, and neurologic complications were documented. Results No statistically significant value was observed in the mean duration of analgesia between the patients in ACB (348.33 minutes) and the patients in FNB (363.06 minutes). No motor block was observed in 12 patients who received ACB, while only four patients had a motor-sparing effect among those who received FNB. No neurological adverse effects were observed in the study participants. Conclusions ACB provides an equal duration of analgesia similar to FNB, and ACB significantly spares motor strength and maintains higher quadriceps power than FNB.

摘要
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8a74/11325116/a75fd2f31f4f/cureus-0016-00000064625-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8a74/11325116/a75fd2f31f4f/cureus-0016-00000064625-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8a74/11325116/a75fd2f31f4f/cureus-0016-00000064625-i01.jpg

相似文献

[1]
Adductor Canal Block Versus Femoral Nerve Block for Postoperative Pain Management in Anterior Cruciate Ligament Reconstruction: A Prospective Interventional Study.

Cureus. 2024-7-15

[2]
Effect of Adductor Canal Block Versus Femoral Nerve Block on Quadriceps Strength, Function, and Postoperative Pain After Anterior Cruciate Ligament Reconstruction: A Systematic Review of Level 1 Studies.

Am J Sports Med. 2019-12-4

[3]
Femoral nerve block versus adductor canal block for postoperative pain control after anterior cruciate ligament reconstruction: A randomized controlled double blind study.

Saudi J Anaesth. 2015

[4]
Adductor Canal Block Versus Femoral Nerve Block for Pain Control After Anterior Cruciate Ligament Reconstruction: A Prospective Randomized Trial.

Am J Sports Med. 2018-12-17

[5]
Adductor Canal Block Provides Noninferior Analgesia and Superior Quadriceps Strength Compared with Femoral Nerve Block in Anterior Cruciate Ligament Reconstruction.

Anesthesiology. 2016-5

[6]
Quadriceps Strength Deficits After a Femoral Nerve Block Versus Adductor Canal Block for Anterior Cruciate Ligament Reconstruction: A Prospective, Single-Blinded, Randomized Trial.

Orthop J Sports Med. 2018-9-26

[7]
Adductor Canal Nerve Versus Femoral Nerve Blockade for Pain Control and Quadriceps Function Following Anterior Cruciate Ligament Reconstruction With Patellar Tendon Autograft: A Prospective Randomized Trial.

Arthroscopy. 2019-2-4

[8]
Adductor Canal Versus Femoral Nerve Block after Anterior Cruciate Ligament Reconstruction: A Systematic Review of Level I Randomized Controlled Trials Comparing Early Postoperative Pain, Opioid Requirements, and Quadriceps Strength.

Arthroscopy. 2020-7

[9]
Adductor canal block versus femoral nerve block combined with sciatic nerve block as an anesthetic technique for hindfoot and ankle surgery: A prospective, randomized noninferiority trial.

Medicine (Baltimore). 2016-12

[10]
Contribution of Multimodal Analgesia to Postoperative Pain Outcomes Immediately After Primary Anterior Cruciate Ligament Reconstruction: A Systematic Review and Meta-analysis of Level 1 Randomized Clinical Trials.

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本文引用的文献

[1]
Comparison of Analgesic Effects of Continuous Femoral Nerve Block, Femoral Triangle Block, and Adductor Block After Total Knee Arthroplasty: A Randomized Clinical Trial.

Clin J Pain. 2024-6-1

[2]
Strategies for successful lumbar neuraxial anaesthesia and analgesia in patients with challenging anatomy.

BJA Educ. 2024-2

[3]
A Comparative Evaluation of Intra-articular Bupivacaine vs Bupivacaine and Dexmedetomidine for Postoperative Analgesia in Arthroscopic Knee Surgeries.

Cureus. 2023-8-23

[4]
The Anterior Cruciate Ligament: Principles of Treatment.

Cureus. 2023-6-11

[5]
Motor-Sparing Effect of Adductor Canal Block for Knee Analgesia: An Updated Review and a Subgroup Analysis of Randomized Controlled Trials Based on a Corrected Classification System.

Healthcare (Basel). 2023-1-10

[6]
Fluoroscopy-Guided Splanchnic Nerve Block for Cancer-Associated Pain.

Cureus. 2022-10-31

[7]
Adductor canal block versus femoral nerve block for pain control after total knee arthroplasty: A systematic review and Meta-analysis.

Medicine (Baltimore). 2022-8-26

[8]
A guide to regional analgesia for Total Knee Arthroplasty.

EFORT Open Rev. 2021-12-10

[9]
Regional anesthesia for orthopedic procedures: What orthopedic surgeons need to know.

World J Orthop. 2022-1-18

[10]
Anterior Cruciate Ligament Injury: Conservative Versus Surgical Treatment.

Cureus. 2021-12-6

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