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Comparison ultrasound-guided adductor canal block and surgeon-performed block for pain management after total knee arthroplasty: a prospective randomized controlled study.
Cakmak, Mehmet Fevzi; Horoz, Levent; Arslan, Fatma Nur; Demir, Onur Utku; Basarir, Kerem.
Afiliação
  • Cakmak MF; Department of Orthopedics and Traumatology, Kirsehir Ahi Evran University, Kirsehir, Turkey. mehmet.cakmak@ahievran.edu.tr.
  • Horoz L; Department of Orthopedics and Traumatology, Kirsehir Ahi Evran University, Kirsehir, Turkey.
  • Arslan FN; Department of Anesthesiology, Kirsehir Ahi Evran University, Kirsehir, Turkey.
  • Demir OU; Department of Orthopedics and Traumatology, Kirsehir Ahi Evran University, Kirsehir, Turkey.
  • Basarir K; Department of Orthopedics and Traumatology, Halic University, Istanbul, Turkey.
BMC Musculoskelet Disord ; 25(1): 637, 2024 Aug 10.
Article em En | MEDLINE | ID: mdl-39127622
ABSTRACT

OBJECTIVE:

Adductor canal block (ACB) is widely performed for postoperative analgesia for total knee arthroplasty (TKA). The aim of this study is to compare surgeon-assisted and anesthesiologist-assisted (ultrasound-guided) adductor blocks in terms of postoperative analgesic efficacy.

METHODS:

This study was designed as a double-blind, prospective and randomized trial. A total of 240 participants were randomly allocated to three groups one where the surgeon performed the adductor canal block (ACBs), another where it was conducted by an anesthetist with ultrasound guidance (ACBa), and a third group without the adductor block. The follow-up management after the Total Knee Arthroplasty (TKA) procedure occurred on the first, third, and tenth days, as well as the twelfth week. Outcome measures comprised pain assessment using the Visual Analog Scale (VAS) and monitoring opioid analgesic consumption.

RESULTS:

No significant differences in demographic profiles were observed between the groups. Groups ACBa and ACBs exhibited significantly lower VAS scores compared to the control group at both 3 and 12 h after surgery, with group ACBa showing the lowest VAS scores among all groups. However, at 1 day, 3 days, 10 days and 12 weeks after surgery, there was no significant difference in VAS scores between the ACBa and ACBs groups. On the first three days, the ACBa group had the lowest opioid consumption and the lowest total opioid consumption. The differences in VAS scores between the groups began to decrease on the first day after surgery.

CONCLUSION:

The adductor canal block (ACB) has been demonstrated to be an effective method of reducing pain in patients undergoing total knee replacement (TKR) in the postoperative period. Nevertheless, despite the pronounced impact that ACB performed by an anesthesiologist under ultrasound guidance has on VAS scores according to intraoperative ACB by surgeons, its effect on clinical outcomes has not been demonstrated. TRIAL REGISTRATIONS This study was retrospectively registered with the Clinical Trials Registry Platform on July 31, 2024 (NCT06533085).
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Dor Pós-Operatória / Medição da Dor / Ultrassonografia de Intervenção / Artroplastia do Joelho / Bloqueio Nervoso Limite: Aged / Female / Humans / Male / Middle aged Idioma: En Revista: BMC Musculoskelet Disord Ano de publicação: 2024 Tipo de documento: Article

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Dor Pós-Operatória / Medição da Dor / Ultrassonografia de Intervenção / Artroplastia do Joelho / Bloqueio Nervoso Limite: Aged / Female / Humans / Male / Middle aged Idioma: En Revista: BMC Musculoskelet Disord Ano de publicação: 2024 Tipo de documento: Article