Effect of introduction of routine single shot adductor canal block in primary total knee arthroplasty in a rural Australian setting.

Abstract

There is a growing demand for quality osteoarthritis management available in Australia. There has been increasing emphasis on post-total knee replacement pain relief as a significant issue, especially in the context of postoperative recovery protocols which focus on early mobility. The aim of this study was to assess if the addition of adductor canal blocks (ACB) reduced postoperative pain and affected mobility post primary total knee arthroplasty (TKR) at Armidale Rural Referral Hospital (ARRH). A retrospective cohort study was performed of unilateral TKR patients before and after the addition of adductor canal blocks to the TKR protocol at ARRH. Forty-seven patients were included in the study who are matched for age and radiographic disease severity. All patients were prescribed post-operative analgesia per the protocol. Patients who received an ACB had a significant difference in opioid consumption in the first 24 h post-operative compared with those who did not, 115.90 mg oral morphine compared to 66.07 mg (P= 0.0001). This was also supported by a significant difference in patient self-rated numerical pain score between groups, no ACB group 3.09/10 and ACB group 1.05/10 (P= 0.0001). The ACB group were able to mobilize further on post-op days 1 and 2 than those who did not receive an ACB with the ACB group (P= 0.0001 and 0.0008). This adds to the evidence supporting the use of Adductor Canal Blocks in patients undergoing total knee arthroplasty, of especial significance in a rural population.