Adductor Canal Block Plus Lateral Femoral Cutaneous Nerve Block for Pain Control After TKA .
Ultrasound-guided adductor canal block combined with lateral femoral cutaneous nerve block for post-operative analgesia following total knee arthroplasty: a prospective, double-blind, randomized controlled study
Int Orthop. 2021 Jun;45(6): 1421-1429.One hundred and sixty-eight patients aged 50-80 scheduled for a primary total knee arthroplasty (TKA) were randomized to receive an adductor canal block plus a lateral femoral cutaneous nerve block (n=84) or standard peri-articular infiltration (n=84) for the management of post-operative pain. The primary outcome of interest included pain at rest and during activity on a visual analogue scale (VAS) during the first 48 hours and at the time of discharge, as well as morphine consumption and duration of analgesia. Secondary outcomes of interest included knee range of motion, quadriceps strength, time to first mobilization, daily mobilization distance, length of stay, Knee Society Score (KSS) function scores, and the incidence of adverse events. Results revealed significantly lower VAS pain scores at rest up to 12 hours post-operation, lower VAS pain scores during activity up to 8 hours post-operation, and lower morphine consumption in the first post-operative day in the combination group compared to the infiltration group (p<0.05 for all). Moreover, analgesic duration was significantly longer in the combination group (p<0.001). No significant differences between groups were observed in all secondary outcomes (p>0.05 for all).
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