Knee Surg Relat Res.  2017 Jun;29(2):87-95. 10.5792/ksrr.16.039.

Femoral Nerve Block versus Adductor Canal Block for Analgesia after Total Knee Arthroplasty

• Koh IJ
• Choi YJ
• Kim MS
• Koh HJ
• Kang MS
• In Y

• KMID: 2379431
• DOI: http://doi.org/10.5792/ksrr.16.039

Abstract

Inadequate pain management after total knee arthroplasty (TKA) impedes recovery, increases the risk of postoperative complications, and results in patient dissatisfaction. Although the preemptive use of multimodal measures is currently considered the principle of pain management after TKA, no gold standard pain management protocol has been established. Peripheral nerve blocks have been used as part of a contemporary multimodal approach to pain control after TKA. Femoral nerve block (FNB) has excellent postoperative analgesia and is now a commonly used analgesic modality for TKA pain control. However, FNB leads to quadriceps muscle weakness, which impairs early mobilization and increases the risk of postoperative falls. In this context, emerging evidence suggests that adductor canal block (ACB) facilitates postoperative rehabilitation compared with FNB because it primarily provides a sensory nerve block with sparing of quadriceps strength. However, whether ACB is more appropriate for contemporary pain management after TKA remains controversial. The objective of this study was to review and summarize recent studies regarding practical issues for ACB and comparisons of analgesic efficacy and functional recovery between ACB and FNB in patients who have undergone TKA.

Keyword

Knee; Arthroplasty; Pain management; Nerve block; Saphenous nerve; Femoral nerve

MeSH Terms

Accidental Falls
Analgesia*
Arthroplasty
Arthroplasty, Replacement, Knee*
Early Ambulation
Femoral Nerve*
Humans
Knee
Nerve Block
Pain Management
Peripheral Nerves
Postoperative Complications
Quadriceps Muscle
Rehabilitation