J Korean Orthop Assoc.  2019 Apr;54(2):120-126. 10.4055/jkoa.2019.54.2.120.

Comparison of the Effects of an Adductor Canal Block and Periarticular Multimodal Drug Local Injection on Pain after a Medial Opening High Tibial Osteotomy

• Kim OG
• Kim DH
• Seo SS
• Lee IS

• KMID: 2444776
• DOI: http://doi.org/10.4055/jkoa.2019.54.2.120

Abstract

PURPOSE
The efficacy of periarticular multimodal drug injection and adductor canal block after a medial opening-wedge high tibial osteotomy was compared in terms of the postoperative pain level.
MATERIALS AND METHODS
From November 2016 to March 2017, 60 patients underwent a medial opening-wedge high tibial osteotomy under spinal anesthesia. Preemptive analgesic medication, intravenous patient controlled anesthesia were used for pain control in all patients. Thirty patients received a periarticular multimodal drug injection (group I), and 30 patients received an adductor canal block (group II). These two groups were compared regarding the postoperative pain level, frequency of additional tramadol injections, total amount of patient-controlled analgesia, and number of times that the patients pushed the patient-controlled analgesia button at each time interval.
RESULTS
The visual analogue scale scores over the two-week postoperative period showed no statistical significance. The frequency of additional tramadol hydrochloride injections was similar in the two groups over time. The mean number of times that patients pushed the patient-controlled analgesia button was similar in two groups over time. The total amount of patient-controlled analgesia was similar in the two groups over time.
CONCLUSION
This study shows that intraoperative periarticular multimodal drug injections and adductor canal block may have a similar effect on postoperative pain control in patients who have undergone a medial opening-wedge high tibial osteotomy for unicompartmental osteoarthritis of the knee.

Keyword

knee; osteoarthritis; osteotomy; injections; nerve block

MeSH Terms

Analgesia, Patient-Controlled
Anesthesia
Anesthesia, Spinal
Humans
Knee
Nerve Block
Osteoarthritis
Osteotomy*
Pain, Postoperative
Postoperative Period
Tramadol
Tramadol

Figure

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  Figure 1 Photograph illustrating intraoperative periarticular injection.

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  Figure 2 Photograph illustrating procedure of an adductor canal block.

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  Figure 3 Comparison of postoperative VAS scores between groups. VAS, visual analogue scale; PMDI, periarticular multimodal drug injection; ACB, adductor canal block.

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  Figure 4 Comparison of frequency of additional tramadol hydrochloride injections between groups. PMDI, periarticular multimodal drug injection; ACB, adductor canal block.

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  Figure 5 Comparison of mean number of times that patients pushed patient controlled analgesia button between groups. PMDI, periarticular multimodal drug injection; ACB, adductor canal block.

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  Figure 6 Comparison of total amount of fentanyl consumption between groups. PMDI, periarticular multimodal drug injection; ACB, adductor canal block.

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