Adductor Canal vs Femoral Nerve Block for Outpatient ACL Reconstruction .
The Effectiveness of Adductor Canal Block Compared to Femoral Nerve Block on Readiness for Discharge in Patients Undergoing Outpatient Anterior Cruciate Ligament Reconstruction: A Multi-Center Randomized Clinical Trial.
J Clin Med . 2023 Sep 17;12(18):6019.Fifty-three patients undergoing outpatient ACL reconstruction were randomized to receive either a femoral nerve block (n=26) or an adductor canal block (ACB)(n=27). The primary outcome was readiness for discharge, defined as a Post-Anesthetic Discharge Scoring System (PADSS) score ≥9. Secondary outcomes included motor block, (near) falls, opioid consumption, mobilization, pain scores, Overall Benefit of Analgesia Score (OBAS), and long-term function (SF-36 and KOOS) up to 12 weeks. No difference in readiness for discharge was observed between groups. However, motor block and (near) falls were more frequent after FNB, while opioid use in the PACU was lower with FNB. Pain, OBAS, and long-term outcomes did not differ. Overall, the results revealed that while both blocks provided adequate analgesia and similar discharge times, ACB had a better safety profile with fewer motor complications. The findings suggest ACB should be preferred over FNB despite slightly higher immediate opioid use.
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