Journals / Acta Orthopaedica et Traumatologica Turcica / 2019 / Cilt: 53 - Sayı: 5

Continuous adductor canal block following total knee arthroplasty provides a better analgesia compared to single shot: A prospective randomized controlled trial

Pages
334–339
DOI
—
🏛️Bibliographic metadata and full text access for this article are provided via DergiPark.
DergiPark Record ↗
✨

AI Summary & Key Takeaways

AI Insight
⚡ TL;DR(Too Long; Didn't Read)

Patients treated with continuous adductor canal block also displayed better ambulation and functional recovery following total knee arthroplasty.

📌 3 Key Takeaways

🎯
Objective & Hypothesis:Objective: The aim of this study was to compare single-shot adductor canal block and continuous infusion adductor canal block techniques in total knee arthroplasty patients.
📊
Key Findings & Data:Methods: We prospectively randomized 123 patients who were scheduled for unilateral primary total knee arthroplasty surgery into single shot (n ¼ 60; mean age: 67.1 ± 6.9 years) and continuous (n ¼ 63; mean age: 66.9 ± 6.8 years) adductor canal block groups.
💡
Conclusion & Impact:Patients treated with continuous adductor canal block also displayed better ambulation and functional recovery following total knee arthroplasty.
🔬Design:Research Article
📍Scope:Comprehensive Sample
⚙️Variables:Domain Parameters

Özet

Objective: The aim of this study was to compare single-shot adductor canal block and continuous infusion adductor canal block techniques in total knee arthroplasty patients. Methods: We prospectively randomized 123 patients who were scheduled for unilateral primary total knee arthroplasty surgery into single shot (n ¼ 60; mean age: 67.1 ± 6.9 years) and continuous (n ¼ 63; mean age: 66.9 ± 6.8 years) adductor canal block groups. Postoperative visual analog scale pain scores, need for additional opioids and functional results as; timed up and go test, the 30-s chair stand test, 5 times sit-to-stand test, the 6-min walking test, the time to active straight leg raise, time to walking upstairs, maximal flexion at the time of discharge, duration of stay in hospital were compared between the two groups. Results: Pain scores were lower in the continuous adductor canal block group as compared to the single-shot adductor canal block group throughout the postoperative period (p ¼ 0.001). Rescue analgesia was required for 6 (10%) patients in the single shot group and for 1 (1.59%) patient in the continuous group (p ¼ 0.044). Patients in the continuous adductor canal block group displayed better functional results than the single-shot adductor canal block group with respect to active straight-leg rise time (25.52 ± 4.56 h vs 30.47 ± 8.07 h, p ¼ 0.001), 6-min walking test (74.52 ± 29.38 m vs 62.18 ± 33.32 m, p ¼ 0.035) and maximal knee flexion degree at discharge (104.92 ± 5.35 vs 98.5 ± 7.55, p ¼ 0.001). There was no significant difference between the two groups for other functional and ambulation scores. Conclusion: Pain control following total knee arthroplasty was found to be better in those patients treated with continuous adductor canal block as compared to those treated with single-shot adductor canal block. Patients treated with continuous adductor canal block also displayed better ambulation and functional recovery following total knee arthroplasty.

🔖

Cite This Article

CANBEK, U., AKGÜN, U., AYDOĞAN, N. H., KILINÇ, C. Y., UYSAL, A. İ. (2019). Continuous adductor canal block following total knee arthroplasty provides a better analgesia compared to single shot: A prospective randomized controlled trial. Acta Orthopaedica et Traumatologica Turcica, Cilt: 53 - Sayı: 5, 334–339. https://ajindex.com/articles/146376

References (11)

  1. Elmallah RK, Cherian JJ, Pierce TP, Jauregui JJ, Harwin SF, Mont MA. New and common perioperative pain management techniques in total knee arthroplasty. J Knee Surg. 2016;29(2):169e178. https://doi.org/10.1055/s-0035- 1549027
  2. Terkawi AS,Mavridis D, Sessler DI, et al. Painmanagementmodalities after total knee arthroplasty: a network meta-analysis of 170 randomized controlled trials. Anesthesiology. 2017;126(5):923e937.
  3. Gonzales J, Lovald ST, Lau EC, Ong KL. Risk of opioid-related adverse events after primary and revision total knee arthroplasty. J Surg Orthop Adv. 2018;27(2):148e154.
  4. Elmallah RK, Chughtai M, Khlopas A, et al. Pain control in total knee arthroplasty. J Knee Surg. 2018;31(6):504e513.
  5. Kovalak E, Dogan AT, Uzumcugil O, et al. A comparison of continuous femoral nerve block and periarticular local infiltration analgesia in the management of early period pain developing after total knee arthroplasty. Acta Orthop Traumatol Turc. 2015;49(3):260e266.
  6. Li D, Yang Z, Xie X, Zhao J, Kang P. Adductor canal block provides better performance after total knee arthroplasty compared with femoral nerve block: a systematic review and meta-analysis. Int Orthop. 2016;40(5):925e933. https:// doi.org/10.1007/s00264-015-2998-x
  7. Zhao XQ, Jiang N, Yuan FF, Wang L, Yu B. The comparison of adductor canal block with femoral nerve block following total knee arthroplasty: a systematic review with meta-analysis. J Anesth. 2016;30(5):745e754. https://doi.org/ 10.1007/s00540-016-2194-1
  8. Jenstrup MT, Jaeger P, Lund J, et al. Effects of adductor-canal-blockade on pain and ambulation after total knee arthroplasty: a randomized study. Acta Anaesthesiol Scand. 2012;56(3):357e364. https://doi.org/10.1111/j.1399- 6576.2011.02621.x
  9. Scivoletto G, Tamburella F, Laurenza L, Foti C, Ditunno JF, Molinari M. Validity and reliability of the 10-m walk test and the 6-min walk test in spinal cord injury patients. Spinal Cord. 2011;49(6):736e740. https://doi.org/10.1038/ sc.2010.180
  10. Yeung TS, Wessel J, Stratford P, Macdermid J. Reliability, validity, and responsiveness of the lower extremity functional scale for inpatients of an orthopaedic rehabilitation ward. J Orthop Sports Phys Ther. 2009;39(6): 468e477.
  11. Grosu I, Lavand'homme P, Thienpont E. Pain a