Comparison between Adductor Canal Nerve Block and Femoral Nerve Block in Postoperative Pain Management after Arthroscopic Knee Surgeries

Abstract

Background: Knee arthroscopy is one of the surgeries of lower limbs, which are associated with postoperative pain and the patients generally require a significant amount of opioid-based analgesics after such procedures. Treatment of the postoperative pains after surgical operations of lower limbs is of special importance. Inadequate treatment of these pains results in the reduction of patient's activities and related complications. Objective: To evaluate and compare the efficacy, duration of sensory block, duration of postoperative analgesia and complication between adductor canal block (ACB) and femoral nerve block (FNB). Patients and methods: This randomized controlled study was conducted at Sohag University Hospital. Fourty patients undergoing elective arthroscopic knee surgeries under general anesthesia were included in the study after giving written and informed consents. Results: In our study, there was a statistically significant difference between the studied groups regarding onset and duration of sensory block peak (both were higher in ACB group). Regarding VAS, there was a statistically non-significant difference between the studied groups preoperatively and at 3, 6 and 12 hours postoperatively, while significant difference was detected between them at 24 hours postoperatively (higher VAS score in ACB group at 24 hours). On assessing change overtime in each group, the difference was statistically significant (significant fluctuation over time). But, there was statistically non significant difference between the studied groups regarding modified Ramsey before or one hour after nerve block. Conclusion: ACB provided comparable analgesic efficacy and facilitated earlier mobilization by sparing quadriceps strength compared to FNB.