2023 ISAKOS Biennial Congress ePoster
Effect of Direct Adductor Canal Block Performed by a Surgeon in a Patient Who Underwent Simultaneous Bilateral TKA
Man-Soo Kim, MD, PhD, Seoul KOREA, REPUBLIC OF
Dongho Kwak, MD, Seoul KOREA, REPUBLIC OF
Sungcheol Yang, MD, Seoul KOREA, REPUBLIC OF
Hyukjin Jang, MD, Seoul KOREA, REPUBLIC OF
Ryu Kyoung Cho, MD, Seoul KOREA, REPUBLIC OF
Yong In, MD, PhD, Seoul KOREA, REPUBLIC OF
Seoul St. Mary's Hospital, Seoul, KOREA, REPUBLIC OF
FDA Status Cleared
Summary
Direct adductor canal block performed by a surgeon during surgery showed significant effects on pain reduction and ROM recovery up to 1 day after surgery. Direct adductor canal block can be considered as an effective alternative to adductor canal block using ultrasonography.
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Abstract
Introduction
Effective pain control in the early postoperative period after total knee arthroplasty (TKA) is essential not only for rapid recovery but also for early discharge after surgery. For such pain control, a multimodal pain management protocol is recognized as an essential part after TKA. The adductor canal block, which is one of the peripheral nerve blocks, is well known to be very effective in controlling the early postoperative pain following TKA. The purpose of this study was to compare the effects of intraoperative direct adductor canal block of one knee in patients who underwent primary simultaneous TKA with those in the other knee that did not receive adductor canal block.
Method
We retrospectively reviewed the data of 45 patients who underwent simultaneous bilateral TKA, collected prospectively. In addition to periarticular injection during surgery, intraoperative direct adductor canal blcok was performed in one knee without the use of ultrasonography and only periarticular injection was performed in the other knee. Pain VAS including resting, range of motion, and walking were measured until 1 week after surgery, and ROM was also investigated. The same measurements were performed at 2 and 6 weeks after surgery. The patient's PROM was evaluated by WOMAC at postoperative 6 weeks.
Result
There was no difference in preoperative pain VAS in both groups (all p > 0.05). The pain VAS on the day of surgery and on the 1st day after surgery was confirmed that the ACB group had significantly greater pain reduction compared to non-ACB group (p < 0.05). However, there was no difference of pain level and ROM between the two groups on the 2nd and 6th days after surgery (all p > 0.05). This pattern remained the same at 2 and 6 weeks after surgery (all p > 0.05). Until the 1st day after surgery, the ROM also showed a superior pattern in the ACB group (p < 0.05). However, there was no difference between the two groups from the second day after surgery (p > 0.05). There was no significant difference between the two groups in WOMAC score 6 weeks after surgery (p > 0.05).
Conclusion
Direct adductor canal block performed by a surgeon during surgery showed significant effects on pain reduction and ROM recovery up to 1 day after surgery. Direct adductor canal block can be considered as an effective alternative to adductor canal block using ultrasonography.