An Evaluation of Ultrasound-Guided Adductor Canal Blockade for Postoperative Analgesia After Medial Unicondylar Knee Arthroplasty

Anesthesia and Analgesia
Daryl S HenshawRobert S Weller

Abstract

Unicondylar knee arthroplasty (UKA) is a commonly performed procedure with significant expected postoperative pain. Peripheral nerve blocks are 1 analgesic option, but some approaches may decrease quadriceps motor strength and interfere with early ambulation. In this study, we compared the analgesia provided by an adductor canal block (ACB) and a psoas compartment block (PCB) after UKA. We hypothesized that the ACB would provide equivalent analgesia, defined as a difference of <2 points on the pain scale (0-10 numeric rating scale [NRS]), at rest and with movement 6 hours after block placement. One hundred fifty patients undergoing medial UKA were randomly assigned to receive either an ACB or a PCB with 0.25% bupivacaine, 5 μg/mL epinephrine, and 1.67 μg/mL clonidine. All patients received multimodal analgesics, sham blockade at the alternate site, and a posterior capsule injection during surgery. Patients and observers were blinded to treatment groups. The primary end points were NRS pain scores with rest and movement at 6 hours. Secondary end points included quadriceps muscle strength at 6 hours (0-5 [5 being full strength]; Medical Research Council scale) as well as NRS pain scores, opioid consumption, and opioid-related sid...Continue Reading

References

May 3, 2003·Journal of Pain and Symptom Management·John T FarrarBrian L Strom
Apr 6, 2004·The Orthopedic Clinics of North America·R M Dominic MeekClive P Duncan
Apr 4, 2007·The Journal of Bone and Joint Surgery. American Volume·Steven KurtzMichael Halpern
Aug 25, 2007·Anesthesia and Analgesia·Ken KardashAna Miriam Velly
Mar 25, 2008·The Journal of Arthroplasty·Daniel L RiddleFred J McGlynn

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Citations

Jan 19, 2017·The Journal of Bone and Joint Surgery. American Volume·Gwo-Chin Lee
Nov 7, 2019·The Cochrane Database of Systematic Reviews·Alexander SchnabelChristine H Meyer-Frießem
Apr 10, 2020·The Clinical Journal of Pain·Chun-Guang WangQian Zhang
Apr 7, 2021·Journal of Clinical Anesthesia·Lu QinShishun Zhao

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