The Effect of Femoral Nerve Block and Adductor Canal Block Methods on Patient Satisfaction in Unilateral Knee Arthroplasty: Randomized Non-Inferiority Trial

Abstract

Introduction: Femoral Nerve Block (FNB) and Adductor Canal Block (ACB) methods, which are regional analgesic techniques, are successfully used in postoperative pain control after total knee arthroplasty. This study aimed to compare adductor canal block method that was preoperatively used and femoral nerve block method in total knee arthroplasty (TKA) patients who underwent spinal anesthesia in terms of factors effecting patient satisfaction and determine whether these methods were equally effective or not. Methods: A total of 80 patients between the ages of 60 and 75 who were in the American Society of Anesthesia (ASA) physical status of I-III were prospectively included in this randomized study. Patients (n = 40) who received FNB were called Group FNB and patients (n = 40) who received Adductor Canal Block were called Group ACB. Results: Although mean postoperative VAS values were lower in FNB group only in the first hour (p = 0.02) there was no significant difference between the groups in the third, fifth, seventh, ninth, 12th and 24th hours (p≥0.05). Although Bromage scores were lower in FNB group in the first, second, third, fourth and fifth hours there was no statistically significant difference between the groups (p≥0.05). When mobilization time, patient satisfaction level, time of first analgesia, intraoperative sedation need, and recovery time of sensorial block were compared no statistically significant difference was found (p≥0.05). Discussion: When ACB and FNB that are used for postoperative analgesia in patients who undergo total knee arthroplasty are compared in terms of factors affecting patient satisfaction it is observed that they result in the same level (non-inferiority) of patient satisfaction. Conclusion: We recommend the routine use of ACB method with FNB in total knee arthroplasty. More studies focusing especially on measuring patient satisfaction are needed.

Adductor Canal Block versus Femoral Nerve Block in Total Knee Arthroplasty

“…After removing duplicates, 426 papers underwent eligibility screening. A total of 3308 (1169 SACB; 524 SFNB; 968 CACB; 647 CFNB) patients from 36 studies were included 25–60 with an exclusion list presented in Supplemental Material, http://links.lww.com/CJP/B109.…”

A comparative randomized controlled study of modified 4 in 1 block versus IPACK plus adductor canal block for post-operative analgesia in total knee arthroplasty

“…[ 5 , 9 , 12 ] Studies show ACB is superior to FNB, by sparing quadriceps weakness. [ 12 , 17 , 23 , 24 ] Posterior knee is supplied by branches from the sciatic nerve, and ACB alone will be inadequate. [ 15 , 16 ] ACB + PSNB has the disadvantage of performing both the blocks in different positions and also some unwanted motor weakness with sciatic nerve block limiting the mobilisation and delay in rehabilitation.…”

Peripheral Nerve Block for Pain Management after Total Hip Arthroplasty: A Retrospective Study with Propensity Score Matching

“…PNBs provide sufficient analgesia with fewer adverse effects, such as neurological complications, nausea, and hypotension than epidural or intravenous patient-controlled analgesia (PCA) with opioids [4,5,13]. For total knee arthroplasty (TKA), femoral nerve block (FNB) is the most commonly used PNB method, and adductor canal block is an alternative choice that selectively blocks the sensory branch of femoral nerve [14,15]. Various studies have already proved the effectiveness of PNB for TKAs, making PNB an important factor in the ERAS protocol.…”