Adductor Canal Block Versus Femoral Nerve Block for Pain Control After Anterior Cruciate Ligament Reconstruction: Case Closed? Letter to the Editor

Abstract

with great interest the article of Lynch and colleagues 2 in a recent issue of the American Journal of Sports Medicine. The authors performed a randomized study on 60 patients undergoing primary anterior cruciate ligament reconstruction with bone-patellar tendon-bone autograft and concluded that there is similar efficacy in perioperative pain control with the use of an adductor canal block when compared with a femoral nerve block. The authors should be applauded for performing a well-designed study on an important topic (ie, acute pain) in patients undergoing surgery. 4,6 The need to improve postoperative recovery by reducing moderate to severe postoperative pain makes the topic very important in perioperative medicine. 1,5 Although the study of Lynch et al 2 was well conducted, there are some critical points that need to be clarified by the authors to support their findings. First, it is unclear if the subjects received the same intra-and postoperative analgesics, as this has the potential to directly alter the study outcomes. It is possible that patients who were allocated to the femoral nerve group received more intraoperative analgesics and therefore had less pain than those patients in the adductor canal group. Last, it is not clear who collected the study data. It is known that postoperative pain scores collected by clinical nurses are not reliable for analgesic studies. 3 I would welcome comments by the authors, as this would help to further substantiate the findings of this important study.