Primary ArthroplastyEffect of Adductor Canal Block on Acute Perioperative Pain and Function in Total Knee Arthroplasty
Section snippets
Methods
After institutional review board approval was obtained, our institutional database was used to retrospectively identify 2 cohorts of consecutive patients who had undergone unilateral TKA with a single surgeon. Patients who underwent surgery from January 2014 through January 2018 were included, as this time frame captures patients treated with our current TKA perioperative protocol, including use of tranexamic acid (1 g at incision and 1 g at closure), pericapsular injection (0.5% Marcaine with
Results
The ACB + PAI group consisted of 624 patients with a mean age of 64.5 years. There were 237 males (38%) and 387 females (62%) with a mean BMI of 32.6. The percentage of these patients requiring narcotics preoperatively was 29.7%. The PAI-alone group consisted of 69 patients with a mean age of 67.2 years. There were 28 males (41%) and 41 females (59%) with a mean BMI of 31.7. The percentage of these patients requiring narcotics preoperatively for pain control was 31.9%. The PAI group was
Discussion
Poorly controlled pain following TKA can result in diminished function with physical therapy, decreased mobilization, prolonged hospitalization, and reduced patient satisfaction. PAI and ACB have both been implicated as important components in multimodal pain management regimens but the role of ACB remains controversial. To our knowledge, this is the largest retrospective study exploring the role of ACB. We demonstrated improved function with physical therapy and decreased length of
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Cited by (7)
Peripheral regional anaesthesia and outcomes: a narrative review of the literature from 2013 to 2023
2023, British Journal of AnaesthesiaIntraoperative Surgeon Administered Adductor Canal Blockade Is Not Inferior to Anesthesiologist Administered Adductor Canal Blockade: A Prospective Randomized Trial
2020, Journal of ArthroplastyCitation Excerpt :In the anesthesiologist performed group, 2 subjects underwent manipulation under anesthesia, and 1 subject had an unrelated hematoma. ACB has proven effective in reducing pain without providing motor blockade after TKA, either in isolation or as part of multimodal anesthesia with pericapsular injections [4–10]. Grevstad et al and Kuang et al demonstrated that ACB was equivalent in pain control to femoral nerve block without the motor blockade that is associated with femoral nerve blocks [6,7].
Adductor canal block as a part of multimodal analgesia protocol for total knee arthroplasty
2023, Anaesthesia, Pain and Intensive CarePeripheral nerve block anesthesia/analgesia for patients undergoing primary hip and knee arthroplasty: recommendations from the International Consensus on Anesthesia-Related Outcomes after Surgery (ICAROS) group based on a systematic review and meta-analysis of current literature
2021, Regional Anesthesia and Pain Medicine
One or more of the authors of this paper have disclosed potential or pertinent conflicts of interest, which may include receipt of payment, either direct or indirect, institutional support, or association with an entity in the biomedical field which may be perceived to have potential conflict of interest with this work. For full disclosure statements refer to https://doi.org/10.1016/j.arth.2019.02.049.
Source of funding: No outside sources of funding were used for this study.