Effectiveness of Pain Relief Between Adductor Canal Block and Femoral Nerve Block in Total Knee Arthroplasty

Osteoarthritis

This study aims to compare the effectiveness of adductor canal block and femoral nerve block in total knee arthroplasty in general anesthesia. Two block techniques were proved safe and effective in pain control after total knee arthroplasty. But some authors insist that quadriceps muscle power was decreased by femoral nerve block. The study design is a double-blind randomized controlled trial. Fifty patients planed to undergo simultaneously bilateral total knee arthroplasty are randomised to receive ultrasound-guided femoral nerve block on one leg and adductor canal block on the other, in addition to combined general anaesthesia. The primary outcome was comparative postoperative pain in either extremity at four, eight, 12, 24, 72 hours and 7days postoperatively. Secondary comparative outcomes included motor strength by cybex test.

Total knee arthroplasty(TKA) is very popular in nowadays. But almost patients complained of postoperative pain and it affect the delay of early mobilization which prevent knee stiffness, lessens hospital stay and improves overall patient satisfaction and outcome of TKA. Intravenous patient-controlled analgesia (PCA) or epidural analgesia is a conventional postoperative analgesia. Recently other block techniques like a adductor canal block and femoral nerve block were known for good methods of pain relief after TKA. However, femoral nerve block reduces quadriceps muscle strength thereby potentially compromising postoperative mobilization. Therefore, it is necessary to evaluate the effectiveness of pain treatment and the preservation of muscle function after the procedure of adductor canal block and femoral nerve block. The present study aimed to determine and compare the efficacy of adductor canal block and femoral nerve block combined with general anesthesia on (1) postoperative pain control, (2) early patient ambulation and functional recovery and (3) change of muscle power after total knee arthroplasty.