Single-Dose Adductor Canal Block with Local Infiltrative Analgesia Compared with Local Infiltrate Analgesia after Total Knee Arthroplasty: A Randomized, Double-Blind, Placebo-Controlled Trial

Antoun Nader, Mark C. Kendall*, David W. Manning, Matthew Beal, Rohit Rahangdale, Robert Dekker, Gildasio S. De Oliveira, Eric Kamenetsky, Robert J. McCarthy

*Corresponding author for this work

Research output: Contribution to journalArticle

23 Scopus citations

Abstract

Background and Objectives A single-dose adductor canal block can provide postoperative analgesia for patients undergoing total knee arthroplasty (TKA). The purpose of this study was to assess postoperative opioid consumption after ultrasound-guided single-injection bupivacaine compared with saline adductor canal block for patients undergoing TKA. Methods After institutional review board approval, written informed consent was obtained from patients (>18 years old) undergoing elective TKA. Subjects were randomized into 2 groups as follows: adductor canal blockade with 10 mL of bupivacaine 0.25% with epinephrine 1:300,000 or 10 mL of normal saline. All patients received a periarticular infiltration mixture intraoperatively with scheduled and patient requested oral and IV analgesics postoperatively for breakthrough pain. Personnel blinded to group allocation recorded pain scores and opioid consumption every 6 hours. Pain burden, area under the numeric rating score for pain, was calculated for 36 hours. The primary outcome was postoperative IV/IM morphine (mg morEq) consumption at 36 hours after surgery. Results Forty (28 women/12 men) subjects were studied. Postoperative opioid consumption was reduced in the bupivacaine 48 (39 to 61) mg morEq compared with saline 60 (49 to 85) mg morEq, difference -12 (-33 to -2) mg morEq (P = 0.03). Pain burden at rest was decreased in the bupivacaine 71 (37 to 120) score · hours compared with saline 131 (92 to 161) score · hours, difference -60 (-93 to -14) score · hours (P = 0.009). Conclusions Adductor canal blockade with bupivacaine 0.25% with epinephrine 1:300,000 effectively reduces pain and opioid requirement in the postoperative period after TKA. Adductor canal blockade is an effective pain management adjunct for patients undergoing TKA.

Original languageEnglish (US)
Pages (from-to)678-684
Number of pages7
JournalRegional anesthesia and pain medicine
Volume41
Issue number6
DOIs
StatePublished - Nov 1 2016

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine

Fingerprint Dive into the research topics of 'Single-Dose Adductor Canal Block with Local Infiltrative Analgesia Compared with Local Infiltrate Analgesia after Total Knee Arthroplasty: A Randomized, Double-Blind, Placebo-Controlled Trial'. Together they form a unique fingerprint.

  • Cite this