A Comparative Study to Evaluate Postoperative Analgesia with USG Guided Unilateral Adductor Canal by using Combination of Bupivacaine with Dexamethasone or Morphine After Total Knee Replacement

Abstract

TKR surgery refer to surgical intervention in the knee joint to replace diseased joint and many studies investigated post operative pain control, Adductor canal block is a newer alterative to femoral block after TKR with better multimodal analgesia and better quadriceps muscle strength, Many studies investigated the prolongation of analgesic duration when adjunct is added to a local anesthetic. A prospective randomized ,double blind, parallel- two group trial. A total of 78 ASA 1 and ASA 2 patients undergoing total knee replacement were included in the study. Seventy eight patients undergoing TKR were randomly allocated into two groups and received block as per the study protocol and the main outcome measure was the duration of postoperative analgesia. The result revealed that at equal volumes Bupivacaine 0.5% with 30mcg/kg of morphine has an advantage over Bupivacaine 0.5% when combined with 8mg of dexamethasone. We conclude that adductor canal block with 0.5% Bupivacaine with 30mcg/kg of morphine has better outcome over conventional intravenous paracetamol analgesia