Combined adductor canal and sciatic nerve block compared with local intraarticular infiltration analgesia for total knee arthroplasty: a prospective blinded randomized controlled study

Abstract

Background: A combined adductor canal block and sciatic nerve block is an efficient way to obtain postoperative analgesia after total knee replacement that spares the motor power of the femoral nerve. This is a prospective controlled randomized study comparing the efficacy of local infiltrative analgesia (LIA) to a combined adductor canal block and sciatic nerve block (CNB). Methods: Seventy-five patients were included and randomized to two groups. The first (34 patients) received ultrasound guided CNB and the second group (41 patients) received LIA. Results: There was no significant difference in pain control after 4, 6, or 12 hr postoperatively, and there was no significant difference in pain before or after physiotherapy. Both groups achieved knee flexion to 90 degrees at comparable times. Operative time and length of hospital stay were significantly less in the LIA group. Opiate use was similar in both groups. One patient in the LIA group had transient popliteal artery spasm postoperatively. Conclusions: LIA may be comparable in efficacy to combined adductor canal and sciatic nerve block, moreover it is easier and faster to perform.