Efficacy of Adductor Canal Block with Local Infiltration Analgesia Versus Local Infiltration Analgesia Alone for Analgesia in Total Knee Arthroplasty: a Randomized Controlled Trial
Keywords:
total knee arthroplasty, local infiltration analgesia, adductor canal blockAbstract
Objective: The study aims to compare the effectiveness of adductor canal block (ACB) combined with local infiltration analgesia (LIA) to LIA alone in reducing pain for patients undergoing total knee arthroplasty (TKA). The study measured the need for opioid medication within the first 24 hours after surgery; pain scores at rest and during knee movement at 6, 12, 18, and 24 hours after surgery; as well as at the time of the first postoperative opioid medication. Other factors to be considered included the length of hospital stay, opioid side effects, and patient satisfaction.
Methods: This was a randomized controlled trial. Patients scheduled for TKA were randomly divided into two groups, with 27 patients in each group, for a total of 54 patients. One group received ACB combined with LIA, and the second received LIA alone.
Results: Pain scores at rest; 6 hours: ACB + LIA = 3.59 ± 3.05, LIA = 6.81 ± 2.74; 12 hours: ACB + LIA = 3.70 ± 3.16, LIA = 6.59 ± 2.87; 18 hours: ACB + LIA = 4.07 ± 3.08, LIA = 5.74 ± 2.53. Pain scores while moving the knee; 6 hours: ACB + LIA = 4.40 ± 3.46, LIA = 7.75 ± 2.77; 12 hours: ACB + LIA = 5.11 ± 3.05, LIA = 7.33 ± 2.71. There were significant differences between the two groups (p-value < .01). The patient satisfaction scores of the two groups were also significantly different (p-value = .04). However; there were no significant differences between the groups in terms of the amount of opioid analgesic used; the time of the first postoperative opioid medication; opioid side effects; pain scores at rest at 24 hours; pain scores while moving the knee at 18, 24 hours; and the length of hospital stay.
Conclusion: Adductor canal block combined with local infiltration analgesia (LIA), compared with LIA alone, did not show any differences in the amount of opioid medication received in the first 24 hours after TKA surgery. However, it did lead to reduced pain scores and increased patient satisfaction.
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ลิขสิทธิ์บทความเป็นของผู้เขียนบทความ แต่หากผลงานของท่านได้รับการพิจารณาตีพิมพ์ลงวารสารแพทย์เขต 4-5 จะคงไว้ซึ่งสิทธิ์ในการตีพิมพ์ครั้งแรกด้วยเหตุที่บทความจะปรากฎในวารสารที่เข้าถึงได้ จึงอนุญาตให้นำบทความในวารสารไปใช้ประโยชน์ได้ในเชิงวิชาการโดยจำเป็นต้องมีการอ้างอิงถึงชื่อวารสารอย่างถูกต้อง แต่ไม่อนุญาตให้นำไปใช้ในเชิงพาณิชย์
