Abstract
Background/aimTo determine the effectiveness of pregabalin and adductor canal block on opioid consumption, postoperative pain, and fast-tracking.Materials and methodsA total of 51 American Society of Anaesthesiologists (ASA) classification I–II patients aged 18–70 years who were scheduled to undergo elective anterior cruciate ligament reconstruction were included in the study. Patients were randomized into groups P, A, and C. Patients in group P (n = 16), received 150 mg of preoperative oral pregabalin, patients in group A (n = 17) received postoperative adductor canal blockade, and patients in group C (n = 18) received neither adductor canal block nor pregabalin. Surgeries were performed under spinal anaesthesia with hyperbaric bupivacaine following monitorization. Demographic data along with block features, hemodynamic data, mean opioid consumption, numerical rating scale score, White’s fast-track score, and postoperative adverse effects were recorded.ResultsFifty-seven patients were enrolled in the study, and 6 patients were excluded from the study; the data of 51 patients were included in the final analyses. Demographic characteristics and hemodynamic data were similar between the 3groups. Postoperative opioid consumption was significantly lower in groups A and P compared with group C (group P = 178.75 mg, group C = 318.61 mg, group A = 236.47 mg; P < 0.05). The regression of sensory block was significantly slower in group P (P < 0.05). The first analgesic requirement was earlier in group C than in groups P and A (P < 0.05). Patients in group P had higher fast-track scores at 8 h and 12 h compared with group C (P < 0.05); however, group A fast-track scores were similar to those of the other 2groups (P > 0.05). The rate of postoperative adverse effects was similar between the groups (P > 0.05).Conclusion Preoperative pregabalin (150 mg) reduced postoperative opioid consumption as much as adductor canal block in patients undergoing anterior cruciate ligament reconstruction. The first analgesic requirement was earlier in group C than in groups P and A. In addition, pregabalin can prolong the duration of spinal sensory block and shorten the time required to achieve high fast-tracking scores. We recommend the use of both methods as a part of multimodal analgesia.
Highlights
Repair of the anterior cruciate ligament (ACL) is one of the most commonly performed outpatient arthroscopic procedures [1,2]
Fifty-seven patients were enrolled in the study, and 6 patients were excluded from the study; the data of 51 patients were included in the final analyses
Postoperative opioid consumption was significantly lower in groups A and P compared with group C
Summary
Repair of the anterior cruciate ligament (ACL) is one of the most commonly performed outpatient arthroscopic procedures [1,2]. Optimal analgesia facilitates early rehabilitation and mobilization, improves functional recovery, reduces postoperative morbidity, and increases patient satisfaction after anterior cruciate ligament reconstruction (ACLR) [1,3]. Pregabalin is a structural analogue of γ-aminobutyric acid (GABA) acting on the α2δ subunit of voltagedependent calcium channels. The adductor canal block (ACB) has recently gained popularity as an alternative to femoral nerve blockade due to the reduced incidence of quadriceps muscle weakness [2,12]. Several neural structures traverse the canal including the saphenous nerve and its infrapatellar branch, the nerve to the vastus medialis, the posterior branch of the obturator nerve, and in some cases, the medial cutaneous nerve and the anterior branch of the obturator
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