| Title | Continuous Adductor Canal Block used for postoperative pain relief after medial Unicondylar Knee Arthroplasty: a randomized, double-blind, placebo-controlled trial |
| Authors | Lan, Fei Shen, Yanyan Ma, Yanhui Cao, Guanglei Philips, Nicole Zhang, Ting Wang, Tianlong |
| Affiliation | Capital Med Univ, Xuanwu Hosp, Dept Anesthesiol, 45,Changchun St, Beijing 100053, Peoples R China Peking Univ, Dept Anesthesiol, Int Hosp, Beijing, Peoples R China Capital Med Univ, Dept Orthoped, Xuanwu Hosp, Beijing, Peoples R China Univ Toronto, Dept Crit Care Med, St Michaels Hosp, Toronto, ON, Canada |
| Keywords | Knee Arthroplasty Adductor canal block Local Analgesia |
| Issue Date | 2019 |
| Publisher | BMC ANESTHESIOLOGY |
| Abstract | BackgroundPeripheral nerve block and local infiltration analgesia (LIA) provide good analgesia after knee replacement. This study evaluated the additional analgesic efficacy of continuous adductor canal block (ACB) added to single-dose LIA after medial unicondylar knee arthroplasty (UKA). We hypothesized ACB would lower pain scores and facilitate postoperative ambulation.MethodsForty-six patients were enrolled into this double-blind, randomized, placebo-controlled trial. UKA was performed and all patients received single-dose LIA intraoperatively. Patients were randomized into two groups: Group RP receiving 0.2% ropivacaine or Group Con receiving normal saline. A flow at 6mL/h was administered for 48h through a catheter in the adductor canal. Primary outcome was movement pain score at 24h using the numeric rating scale (NRS-11). Secondary outcomes included serial postoperative pain scores, rate of patients with NRS>3 at rest and movement within 24 and 48h postoperatively, time to breakthrough pain, quadriceps motor strength, ambulated distance, catheter related infection and patient satisfaction.ResultsForty-two patients were analyzed. Pain scores with movement at 24h postoperatively were significantly lower in Group RP than that in Group Con (3 vs. 5 NRS, P<0.001). Compared with Group Con, breakthrough pain occurred later in Group RP (18.5 vs 10.0h, P=0.002), serial pain scores at rest and with movement and rate of patients with NRS>3 with movementafter surgery were significantly lower. Quadriceps motor strength was equivalent, however, ambulated distance on postoperative day 1 and 2 in Group Con was significant less (19.7 vs 37.3m, P=0.046; 33.4 vs 59.5m, P=0.002).ConclusionsContinuous adductor canal block added to single-dose LIA offered better analgesia and facilitated ambulation without motor weakness after medial UKA.Trial registrationClinical Trial Registration: ChiCTR-IOR-16008720; Registered 25 June 2016. |
| URI | http://hdl.handle.net/20.500.11897/547321 |
| ISSN | 1471-2253 |
| DOI | 10.1186/s12871-019-0787-6 |
| Indexed | SCI(E) |
| Appears in Collections: | 国际医院 |
