Adductor canal block in combination with posterior capsular infiltration on the pain control after TKA

Zhou, Miaomiao; Ding, Huang; Ke, Jianjuan

doi:10.1007/s11845-017-1647-3

Cited by 24 publications

(37 citation statements)

References 22 publications

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“…LIA is typically employed to reduce post-operative opioid use [4,11,16,22]. Many studies have compared LIA against a nerve block or have examined combined local and regional anesthesia protocols [3,5,10,12,13,20,27,[32][33][34]. Most show no differences, and contradictory results between studies exist.…”

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confidence: 99%

Opioid-Free Total Knee Arthroplasty? Local Infiltration Analgesia Plus Multimodal Blood-Loss Prevention Make it Possible

2019

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Opioids have been widely used in the USA for pain control after total knee arthroplasty (TKA). However, adverse effects, especially the possibility of addiction, have increased interest in opioid-free pain management after surgery. We therefore sought to review current pain management protocols after TKA, focusing especially on opioid-free alternatives. We reviewed the literature on pain management after TKA using Medline (PubMed), through June 30, 2018, using the keywords BTKA^and Banalgesia.^We found 388 articles but chose to analyze the 34 that presented high-quality (levels I and II) evidence. Local infiltration analgesia (LIA) is a good option for reducing the use of post-operative opioids; many reports have compared LIA against a nerve block or studied the synergies between two protocols of loco-regional anesthesia. Multimodal blood-loss prevention is sometimes recommended in combination with opioid-free analgesia. In most studies, however, no differences are reported or contradictory results exist. Post-operative pain management protocols vary so much that it is difficult to strongly favor a determined pathway. Keywords knee. total knee arthroplasty. post-operative pain. opioids. local infiltration analgesia. opioid-free TKA

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confidence: 99%

Opioid-Free Total Knee Arthroplasty? Local Infiltration Analgesia Plus Multimodal Blood-Loss Prevention Make it Possible

2019

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“…12 In this current meta-analysis, an analysis of three studies involving 227 patients demonstrated that ACB plus LIA was associated with a significant reduction in morphine consumption during POD 0 and POD 1 compared with isolated ACB. 12,13,16 No significant difference was found between the two groups on POD 2. Postoperative complications are important parameters in comparing the safety of ACB plus LIA and isolated ACB for pain control after TKA.…”

Section: Discussionmentioning

confidence: 74%

“…the included studies are presented in Table 1. [11][12][13][14][15][16] The risk of bias in the RCTs in this study was independently evaluated by two reviewers according to the criteria of the modified Jadad score. The methodological scores of each can range from 0 to 7; a higher score indicates better methodological quality.…”

Section: Resultsmentioning

confidence: 99%

“…The reference lists of all the articles were also reviewed. Finally, three RCTs 11 – 13 and three non-RCTs 14 – 16 were included for data extraction and meta-analysis.…”

Section: Resultsmentioning

confidence: 99%

“…All six included studies were published between 2016 and 2018 and involved 308 participants in the ACB plus LIA groups and 335 participants in the ACB groups. 11 – 16 Single-shot ACB was performed by a surgeon and the mini-midvastus approach was applied. All included patients were diagnosed with end-stage osteoarthritis.…”

Section: Resultsmentioning

confidence: 99%

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Adductor canal block combined with local infiltration analgesia versus isolated adductor canal block in reducing pain and opioid consumption after total knee arthroplasty: a systematic review and meta-analysis

Lv¹,

Huang²,

Wang³

et al. 2020

J Int Med Res

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Objective To evaluate the efficacy and safety of the addition of local infiltration analgesia (LIA) to adductor canal block (ACB) for pain control after primary total knee arthroplasty (TKA). Methods Two reviewers independently searched for potentially relevant published studies using electronic databases, including PubMed® (1966 to June 2019), Embase® (1974 to June 2019) and Web of Science (1990 to June 2019). The results were pooled using the random-effects model to produce standard mean differences for continuous outcome data and odds ratio for categorical outcome data. Results A total of three randomized controlled trials (RCTs) and three non-RCTs were included for data extraction and meta-analysis. There were significant differences between the two groups regarding the postoperative pain score on postoperative day (POD) 0 and POD 1. The cumulative opioid consumption in the ACB plus LIA groups was significantly lower than that in the ACB groups on POD 0 and POD 1. No significant differences were found in terms of postoperative range of motion or length of hospitalization. Conclusion ACB plus LIA significantly reduced the postoperative pain score on POD 0 and POD 1 compared with isolated ACB. In addition, ACB plus LIA was associated with a significant reduction in opioid consumption during the early postoperative period.

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Combined application of adductor canal block and local infiltration anesthesia in primary total knee arthroplasty: an updated meta-analysis of randomized controlled trials

Xu³

et al. 2021

Arch Orthop Trauma Surg

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Adductor canal block in combination with posterior capsular infiltration on the pain control after TKA

Abstract: Overall, as compared with ACB or LIA, ACB plus PCI appeared to provide more ideal analgesia and patient satisfaction in the first 24 h after operation.

Cited by 24 publications

References 22 publications

Opioid-Free Total Knee Arthroplasty? Local Infiltration Analgesia Plus Multimodal Blood-Loss Prevention Make it Possible

Opioid-Free Total Knee Arthroplasty? Local Infiltration Analgesia Plus Multimodal Blood-Loss Prevention Make it Possible

Adductor canal block combined with local infiltration analgesia versus isolated adductor canal block in reducing pain and opioid consumption after total knee arthroplasty: a systematic review and meta-analysis

Combined application of adductor canal block and local infiltration anesthesia in primary total knee arthroplasty: an updated meta-analysis of randomized controlled trials

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