Continuous epidural versus continuous adductor canal block for postoperative pain management in total knee arthroplasty

Abstract

Background: The aim of the study was to compare the study of continuous epidural and continuous adductor canal block for postoperative pain management in total knee arthroplasty (TKA). Materials and Methods: A total of 150 cases were recruited with 75 cases in each group; patients participated in the study were divided into the adductor canal block (ACB) group and continued epidural group. All the patients received the standardized anesthesia and analgesia on hospitalization. Outcome evaluations included the visual analog scale (VAS) scores during activity and at rest, range of motion, quadriceps strength, complication occurrence, total opioid consumption and sleep disruptions caused by pain, postoperative hospital stay, and postoperative nausea and vomiting (PONV) before discharge in all groups. Results: The lateral VAS scores of the knee were lower in the continuous epidural group at rest and during activity as compared with the ACB group. However, the overall knee VAS score, complication occurrence, total opioid consumption and sleep disruptions caused by pain, and PONV were similar between ACB and epidural groups. The urinary retention in patients receiving continuous epidural was common compared to no retention in the adductor group, early mobilization in the adductor group, and no muscle weakness in the ACB group. Conclusion: The ACB does not relieve the lateral knee pain at an early stage but offers comparable analgesic effect and enhanced effectiveness of the early rehabilitation compared to an epidural in patients who underwent TKA.