A randomized controlled trial to assess the postoperative analgesic efficacy of USG guided adductor canal block compared to conventional analgesia among the patients undergoing arthroscopic anterior cruciate ligament reconstruction

Abstract

Arthroscopic knee surgery can cause significant postoperative pain which has to the potential to delay timely discharge from ambulatory surgical setting. The ultrasound guided adductor canal block may provide superior analgesia over traditional distal saphenous nerve blocks for surgical procedures of knee because ACB block includes saphenous nerve, the nerve to vastus medialis, and potentially the articular contribution of obturator nerve to knee joint. The aim of the study was to compare the postoperative analgesic efficacy of ultrasound guided adductor canal block (ACB) in patients undergoing Arthroscopic Anterior cruciate ligament (ACL) reconstruction with the conventional tramadol analgesia. Materials and Methods: The prospective randomized controlled study was conducted at a tertiary care hospital in Andhra Pradesh among 60 patients with grade I/ II ASA (American Society of anesthesiologists classification) 1 & 2, posted for elective Arthroscopic Anterior cruciate ligament reconstruction who were randomly allocated into each of the two groups: conventional analgesia (tramadol) group and ACB group (Adductor canal block with 20ml of 0.75% ropivacaine). Results: NRS static and dynamic Scores among the patients of ACB group were significantly lower than those among the patients of conventional Tramadol group. The first request for analgesia was significantly earlier in conventional tramadol group (1.717 ± 0.19 hours) when compared with the ACB group (15.33 ± 0.75 hours).the dose frequency also the total dosage of tramadol among patients in conventional tramadol group (3.60+0.674) was significantly higher than that among the patients in ACB group. Conclusion: this RCT demonstrates that USG guided ACB block, as a component of multimodal analgesic regimen provides superior analgesia when compared to conventional analgesia during the 24hr postoperative period in patients undergoing elective Arthroscopic ACL repair. Keywords: Adductor canal block, Arthroscopic an