Comparison of Adductor Canal Block Before Versus After Total Knee Arthroplasty in Terms of Pain, Stress, and Functional Outcomes: A Double-Blinded Randomized Controlled Trial.

この研究はインパクトが大きい可能性があると判断されました。 OEのAIによるハイインパクト指標は、論文が掲載されたジャーナルと論文自体の科学的内容の両方からのシグナルを統合することで、論文の影響力を推定します。 最先端の自然言語処理を用いて開発されたOEハイインパクトモデルは、ジャーナルのインパクトファクターのみよりも、研究の将来の引用実績をより正確に予測します。 これにより、臨床的に意義のある研究をより早く認識することができ、読者は将来の診療を形成する可能性が最も高い論文に焦点を当てることができます。

研究概要

One hundred patients undergoing primary unilateral TKA were randomized to receive an adductor canal block (ACB) either 30 minutes before general anesthesia (n=50) or postoperatively in the post-anesthesia care unit (n=50). All patients also received periarticular local infiltration analgesia. The primary outcome was postoperative morphine consumption as rescue analgesia within 24 hours and during the entire hospitalization. Secondary outcomes included time to first rescue analgesia, intraoperative and postoperative stress responses (cortisol and ACTH levels), postoperative pain, range of knee motion, ambulation distance, time to discharge, chronic pain incidence, and complications. Outcomes were assessed up to 3 months postoperatively. Overall, the study revealed that preoperative ACB significantly reduced morphine consumption, stress markers, pain scores, and the incidence of chronic pain compared to postoperative ACB. These findings suggest that a preoperative ACB provides better pain control, mitigates stress responses, and may lower chronic pain risk in patients undergoing TKA.