The effects of ultrasound-guided adductor canal block versus femoral nerve block on quadriceps strength and fall risk: a blinded, randomized trial of volunteers.
Reg Anesth Pain Med
; 38(4): 321-5, 2013.
Article
in En
| MEDLINE
| ID: mdl-23788068
ABSTRACT
BACKGROUND AND OBJECTIVES:
Adductor canal block (ACB) has been suggested as an analgesic alternative to femoral nerve block (FNB) for procedures on the knee, but its effect on quadriceps motor function is unclear. We performed a randomized, blinded study to compare quadriceps strength following adductor canal versus FNB in volunteers. Our hypothesis was that quadriceps strength would be preserved following ACB, but not FNB. Secondary outcomes included relative preservation of hip adduction and degree of balance impairment.METHODS:
The ACB was performed in one leg and the FNB in the contralateral leg in 16 volunteers using a randomized block sequence. For all blocks, 15 mL of 3% chloroprocaine was injected under ultrasonographic guidance. Maximal voluntary isometric contraction of knee extension and hip adduction was measured at baseline and at 30 and 60 minutes after block. After 60-minute assessments were complete, the second block was placed. A test of balance (Berg Balance Scale) was performed 30 minutes after the first block only.RESULTS:
Quadriceps strength and balance scores were similar to baseline following ACB. Following FNB, there was a significant reduction in quadriceps strength (95.1% ± 17.1% vs 11.1% ± 14.0%; P < 0.0001) and balance scores (56 ± 0 vs 37 ± 17.2; P = 0.02) compared with baseline. There was no difference in hip adductor strength (97.0% ± 10.8% vs 91.8% ± 9.6%; P = 0.17).CONCLUSIONS:
Compared with FNB, ACB results in significant quadriceps motor sparing and significantly preserved balance.
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Procaine
/
Accidental Falls
/
Ultrasonography, Interventional
/
Quadriceps Muscle
/
Muscle Strength
/
Femoral Nerve
/
Anesthetics, Local
/
Nerve Block
Type of study:
Clinical_trials
/
Etiology_studies
/
Risk_factors_studies
Limits:
Adolescent
/
Adult
/
Humans
/
Middle aged
Country/Region as subject:
America do norte
Language:
En
Journal:
Reg Anesth Pain Med
Journal subject:
ANESTESIOLOGIA
/
NEUROLOGIA
/
PSICOFISIOLOGIA
Year:
2013
Document type:
Article
Affiliation country:
United States