Knee Surg Relat Res.  2018 Jun;30(2):133-141. 10.5792/ksrr.17.088.

Does Adductor Canal Block Have a Synergistic Effect with Local Infiltration Analgesia for Enhancing Ambulation and Improving Analgesia after Total Knee Arthroplasty?

• Kampitak W
• Tanavalee
• Ngarmukos
• Amarase C
• Apihansakorn R
• Vorapalux

• KMID: 2413632
• DOI: http://doi.org/10.5792/ksrr.17.088

Abstract

PURPOSE
We compared a single-injection adductor canal block (ACB) with or without local infiltration analgesia (LIA) for accelerating functional recovery and reducing postoperative pain after total knee arthroplasty (TKA).
MATERIALS AND METHODS
Sixty-two patients undergoing TKA with simple spinal analgesia and ACB were randomized to receive either LIA (group A+L) or placebo LIA (group A). Postoperative visual analog scale (VAS) score for pain, Timed Up and Go (TUG) test and quadriceps strength, total dosage of rescue analgesia, time to first rescue analgesia, and adverse events were serially evaluated from postoperative day 1 to 3 months.
RESULTS
There were no differences between both groups in pre- and postoperative VAS, TUG test, quadriceps strength 2 days, 3 days, 2 weeks, 6 weeks, and 3 months postoperatively. There were no differences in Knee Society clinical and function scores at 6 months and 1 year. However, group A+L had a significantly longer time for postoperative rescue analgesia (491 minutes vs. 143 minutes, p=0.04) with less patients requiring rescue analgesia during 6 hours after surgery (16.7% vs. 43.3%, p=0.024). Both groups had similarly high rates of patient satisfaction with low adverse event rates.
CONCLUSIONS
Combined ACB and LIA in TKA enhanced early ambulation with reduced and delayed rescue analgesia.

Keyword

Knee; Arthroplasty; Adductor canal block; Local analgesia; Pain; Ambulation

MeSH Terms

Analgesia*
Arthroplasty
Arthroplasty, Replacement, Knee*
Early Ambulation
Humans
Knee
Pain, Postoperative
Patient Satisfaction
Visual Analog Scale
Walking*