Comparison of the efficacy of ultrasound guided adductor canal block versus intra-articular infiltration in providing post-operative analgesia after arthroscopic anterior cruciate ligament repair surgery

Abstract

Background and Aims: Ultrasound guided adductor canal block (ACB) is a modality for providing analgesia after arthroscopic anterior cruciate ligament repair surgery. Intra-articular infiltration of analgesics in the knee joint acts on the free nerve endings at the operative site and provides analgesia. We aim to compare the analgesic efficacy and opioid consumption between these two modalities. Material and Methods: Sixty patients were randomized to receive either ACB under ultrasound guidance (group A) or intra-articular infiltration (group B). Post-operatively time of rescue analgesia and opioid consumption were noted. Quality of analgesia was assessed every 2 hours until 6 hours, then every 6 hours until 24 hour post-operative period between the two groups. Data was analysed statistically and P value < 0.05 was considered significant. Results: Time of rescue analgesia was comparable in both the groups (p value 0.4317). NRS scores in ACB group and intra-articular infiltration group were comparable till first 6 hours (p value 0.4519) but increased in intra-articular infiltration group at 12 th hour (p value <0.0001) and 18 th hour (p value <0.0117) as compared to group receiving ACB. The opioid consumption was more in intra-articular infiltration group than ACB group although not statistically significant (p value 0.6319). Conclusion: ACB is a better modality for postoperative analgesia after arthroscopic anterior cruciate ligament repair surgery as analgesia of intra-articular infiltration wears off in 12-24 hour period which is crucial for early ambulation and from rehabilitation point of view.