Intraoperative Surgeon Administered Adductor Canal Blockade Is Not Inferior to Anesthesiologist Administered Adductor Canal Blockade: A Prospective Randomized Trial
OrthoEvidence Journal (OE Journal) - ACE Report
OE Journal. 2020;8(11):3 J Arthroplasty . 2020 May;35(5):1228-1232.What this means for my practice?
Results of this study suggest that pain, functional and quality of life outcomes do not significantly differ between a surgeon administered and anesthesiologist administered adductor canal blockade, up to 6 weeks post-operation. However, an anesthesiologist administered adductor canal blockade may provide superior pain relief and functional improvement immediately post-operation compared to a surgeon administered adductor canal blockade. This study was limited, as it was not powered to detect differences in several of the outcomes. Furthermore, the assessment of post-operative day 0 pain was not controlled and could have skewed the results.
Study Summary
Sixty-three patients undergoing total knee arthroplasty were randomized to receive an adductor canal blockade during surgery administered by either the surgeon or anesthesiologist. The primary outcome of interest was pain score as measured by a Visual Analog Scale (VAS). Secondary outcomes of interest included active and passive range of motion in flexion and extension, Knee Injury and Osteoarthritis Outcome Score (KOOS) pain, symptom, activity of daily living, sport and recreation, and quality of life sub-scores, and Short Form 12 (SF-12) mental and physical component scores. Outcomes were assessed up to 6 weeks post-operation. Results of the study revealed significantly favourable VAS pain scores immediately post-operation and active flexion range of motion at post-operative day 1 in the anesthesiologist group compared to the surgeon group. Otherwise, all outcomes were not significantly different between the two groups.
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