Ultrasound-guided adductor canal block combined with lateral femoral cutaneous nerve block for post-operative analgesia
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ORIGINAL PAPER
Ultrasound-guided adductor canal block combined with lateral femoral cutaneous nerve block for post-operative analgesia following total knee arthroplasty: a prospective, double-blind, randomized controlled study Donghai Li 1 & Mohammed Alqwbani 1 & Qiuru Wang 1 & Zhouyuan Yang 1 & Ren Liao 2 & Pengde Kang 1 Received: 21 October 2019 / Accepted: 26 March 2020 # SICOT aisbl 2020
Abstract Purpose The purpose of this study was to investigate whether adductor canal block (ACB) combined with lateral femoral cutaneous nerve block (LFCNB) could improve the efficacy of post-operative analgesia in a comparison with a standard periarticular infiltration analgesia (PIA) after a total knee arthroplasty (TKA). Methods One hundred and sixty patients of scheduled unilateral primary TKA were randomly allocated into two groups for postoperative analgesia. Eighty cases were treated with ACB combined with LFCNB and the other eighty treated with PIA. The primary outcomes were pain visual analogue scale (VAS) and rescue pain killer consumption, and the secondary outcomes were knee active range of motion (ROM), quadriceps strength, patients’ ambulation ability, Knee Society Score (KSS), length of hospital stay, and adverse events. Results We found that ACB combined with LFCNB was better on decreasing the post-operative pain score within 12 hours at rest and 8 h with activity (p < 0.05) and provided longer duration of analgesia (19.91 ± 5.09 VS 12.06 ± 3.67 h, p < 0.01) and less rescue morphine consumption (13.63 ± 9.84 vs 18.00 ± 11.52 mg, p = 0.011) than the PIA. There was no significant difference between the two groups (p > 0.05) in terms of knee ROM, quadriceps strength, daily mobilization distance, KSS, and complication occurrence. Conclusions ACB combined with LFCNB provides a significantly better pain control, less opioid consumption, and longer duration of analgesia than peri-articular infiltration while preserving muscle function without affecting knee functional recovery nor the length of stay or side effects occurrence. Keywords Total knee arthroplasty . Adductor canal block . Lateral femoral cutaneous nerve block . Post-operative analgesia
Electronic supplementary material The online version of this article (https://doi.org/10.1007/s00264-020-04549-2) contains supplementary material, which is available to authorized users. * Pengde Kang [email protected] Donghai Li [email protected]
Ren Liao [email protected]
1
Department of Orthopaedics Surgery, West China Hospital, Sichuan University, 37# Guoxue Road, Chengdu 610041, People’s Republic of China
2
Department of Anesthesiology, West China Hospital, Sichuan University, 37# Guoxue Road, Chengdu 610041, Sichuan Province, China
Mohammed Alqwbani [email protected] Qiuru Wang [email protected] Zhouyuan Yang [email protected]
International Orthopaedics (SICOT)
Introduction Total knee arthroplasty (TKA) has become the most effective method to treat advanced knee osteoarthritis [2]. Despite the tremendous progress that the surgical procedure has achieved, TKA
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