Continuous femoral nerve block is more effective than continuous adductor canal block for treating pain after total knee arthroplasty

Borys, Michał; Domagała, Michał; Wencław, Krzysztof; Jarczyńska-Domagała, Joanna; Czuczwar, Mirosław

doi:10.1097/md.0000000000017358

Cited by 29 publications

(47 citation statements)

References 21 publications

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“…[ 5 , 6 ] Several pain relief methods are available for postoperative analgesia, including patient-controlled intravenous analgesia, intravenous opioids, femoral nerve block, local infiltration analgesia, and epidural. [ 7 – 10 ] However, the most suitable analgesic method remains controversial. Recently, published studies have reported that the adductor canal block (ACB) provides effective postoperative analgesia.…”

Section: Introductionmentioning

confidence: 99%

Is the proximal adductor canal block a better choice than the distal adductor canal block for primary total knee arthroplasty?

Zhang

Chen

et al. 2020

Medicine

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Background: Total knee arthroplasty is accompanied by moderate to severe postoperative pain. Postoperative pain hampers the functional recovery and lowers patient satisfaction with the surgery. Recently, the adductor canal block (ACB) has been widely used in total knee arthroplasty. However, there is no definite answer as to the location of a continuous block within the ACBs. Method: Randomized controlled trials about relevant studies were searched in PubMed (1996 to Oct 2019), Embase (1996 to Oct 2019), and Cochrane Library (CENTRAL, Oct 2019). Results: Five studies involving 348 patients met the inclusion criteria. Pooled data indicated that the proximal ACB was as effective as the distal ACB in terms of total opioid consumption ( P = .54), average visual analog scale (VAS) score ( P = .35), worst VAS score ( P = .19), block success rate ( P = .86), and time of catheter insertion ( P = .54). Conclusions: Compared with the distal ACB, the proximal ACB showed similar analgesic efficacy for total opioid consumption, average VAS score, worst VAS score, block success rate, and time of catheter insertion. However, because of the limited number of involved studies, more high-quality studies are needed to further identify the optimal location of the ACB.

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Section: Introductionmentioning

confidence: 99%

Is the proximal adductor canal block a better choice than the distal adductor canal block for primary total knee arthroplasty?

Zhang

Chen

et al. 2020

Medicine

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“…[ 10 ] Some of the high quality studies have confirmed that ACB and FNB, in total knee arthroplasty, can achieve similar postoperative analgesic effect, but patients with ACB can obtain better early rehabilitation compared with those with FNB. [ 5 – 9 ] Similarly, in a prospective randomized, controlled trial, patients who underwent ACLR were randomized to receive either FNB or ACB, ACB exhibited early relative sparing of quadriceps strength at 6 to 8 hours postanesthesia compared with FNB. [ 1 , 11 – 15 ]…”

Section: Discussionmentioning

confidence: 99%

“…However, FNB is followed by a significant decrease in quadriceps muscle strength, resulting in delayed mobilization, which is associated with the potential risk of falling. [ 5 , 6 ] Within this context, a growing body of evidence supports the use of an adductor canal block (ACB), which offers pure sensory block with minimal motor involvement in patients undergoing ACLR. [ 7 ] An ACB can be expected to include the saphenous nerve, vastus medialis, medial femoral cutaneous, articular branches from the obturator, and the medial retinacular nerves.…”

Section: Introductionmentioning

confidence: 99%

Femoral nerve block vs adductor canal block after anterior cruciate ligament reconstruction under general anesthesia

Xue¹,

Jiang²,

Wang³

et al. 2020

Medicine

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Background: Femoral nerve block (FNB) is considered the preferred analgesia after anterior cruciate ligament reconstruction (ACLR), but leads to weakness in the quadriceps muscles. Adductor canal block (ACB) is a new sensory block technique that effectively relieves postoperative pain while preserving quadriceps strength. The purpose of our study was to compare the efficacy of FNB vs ACB for pain control after ACLR. Methods: This prospective, randomized, double-blind, controlled, superiority clinical trial was approved by the institutional review board in our university hospital. We enrolled 120 patients set to undergo ACLR in this randomized therapeutic trial. Sixty patients received FNB and the other 60 received ACB for postoperative pain control. All ACB and FNB were performed using ultrasound-guided single-shot procedures. The primary outcomes included maximum voluntary isovolumetric contraction and postoperative pain score. Secondary outcomes included total opioid consumption, length of hospital stay, complication, and satisfaction score. Results: This clinical trial might provide some insights to estimate and compare the safety and efficacy of ACB vs FNB following ACLR. Trial registration: This study protocol was registered in Research Registry (researchregistry5569).

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“…This distribution supplies the medial, anterior, and lateral aspects of the knee. In recent years, the ACB has been proposed as a potential successor to the FNB [43][44][45][46] .…”

Section: Therapeutic Consideration Of Urvi Marmamentioning

confidence: 99%

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2020

IJPSR

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Continuous femoral nerve block is more effective than continuous adductor canal block for treating pain after total knee arthroplasty

Abstract: Supplemental Digital Content is available in the text

Cited by 29 publications

References 21 publications

Is the proximal adductor canal block a better choice than the distal adductor canal block for primary total knee arthroplasty?

Is the proximal adductor canal block a better choice than the distal adductor canal block for primary total knee arthroplasty?

Femoral nerve block vs adductor canal block after anterior cruciate ligament reconstruction under general anesthesia

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