Continuous Ultrasound-Guided Adductor Canal Block for Total Knee Arthroplasty

Abstract

A continuous adductor canal block for total knee arthroplasty reduces opioid consumption compared with that of placebo in the first 48 hours after surgery. Other outcomes including quadriceps strength, distance ambulated, and pain scores all show benefit from an adductor canal catheter after total knee arthroplasty but require further study before being interpreted as conclusive.

Single-Dose Adductor Canal Block With Local Infiltrative Analgesia Compared With Local Infiltrate Analgesia After Total Knee Arthroplasty

“…20 Prior studies have examined the use of a continuous adductor canal block via an indwelling catheter placed at the end of surgery or postoperatively after TKA. [21][22][23][24] Andersen et al, 21 Although continuous adductor canal analgesia may potentially provide a more prolonged analgesic effect compared with the single-dose method used in the current study, there are caveats with a continuous catheter approach. 26 Postoperative placement may require removal of surgical dressings and may increase the potential for contamination with perineural injection through an indwelling catheter.…”

Adductor canal blockade for moderate to severe pain after arthroscopic knee surgery: a randomized controlled trial

“…[14][15][16] It has been demonstrated to have a positive impact on post-operative pain and morphine consumption after total knee arthroplasty. 15,17,18 In this trial, we hypothesized that the ACB would reduce pain in patients with moderate to severe pain, defined as a visual analogue scale (VAS) pain score ≥ 40 mm (0 to 100 mm) after arthroscopic knee surgery, compared with placebo. The aim of the trial was therefore to investigate the immediate effect of ACB on post-operative pain during active flexion of the knee (primary end point), at rest, and during a 5-m walk.…”

Relative Contributions of Adductor Canal Block and Intrathecal Morphine to Analgesia and Functional Recovery After Total Knee Arthroplasty

“…A continuous ACB can decrease opioid requirements up to 48 hours postoperatively. 30 It is therefore not possible to ascertain from our results whether the beneficial effect of ITM would persist in the context of a continuous ACB. A second limitation is that, as it stands, the study suggests an analgesic advantage when both ACB and ITM are used, but it is difficult to separate the relative contribution of each intervention towards the analgesic effect.…”