Analgesic Efficacy of Adductor Canal Block After Total Knee Arthroplasty

Abstract

ABS TRACT Objective: Total knee arthroplasty (TKA) is a severely painful procedure even with the administration of extensive multimodal analgesics. We aim to assess whether US-guided adductor canal block (ACB) would improve postoperative pain scores and consequently decrease local anesthetic consumption by means of an epidural catheter with patient-controlled anaesthesia (PCA) device after TKA. Material and Methods: This was a retrospective study. Fifty-eight patients who underwent TKA between June 2015 and June 2016 and were fitted with either an epidural catheter with PCA (group A, n=30) or an epidural catheter with PCA followed by ACB (group B, n=28) were included in the study. PCA consumption during the postoperative 24 h and visual analogue scale (VAS) pain scores at 0, 4 and 24 h were determined. Motor block ending time and local anaesthetic drug consumption were also determined. Results: Basal bupivacaine and total bupivacaine consumption were reduced in group B 24 h postoperatively compared to that in group A. ACB reduced VAS score at 0 and 4 h post-operatively during movement. There was no statistically significant difference between VAS scores for each group at 24 h postoperatively. Motor block duration in group B patients who underwent ACB was longer than group A. Conclusion: Adductor canal block is effective for patients undergoing TKA. US-guided ACB reduced 24 h PCA requirements and VAS scores after TKA. ACB is a promising technique in producing effective and prolonged postoperative analgesia for patients undergoing TKA.