DALLAS — Patients undergoing primary total knee arthroplasty whose adductor canal block was surgeon administered had patient satisfaction, knee range of motion and opioid consumption similar to that of patients whose adductor canal block was anesthesiologist administered, according to results of a prospective randomized trial presented at the American Association of Hip and Knee Surgeons Annual Meeting.
“This would be a good alternative, and cost-effective as well, to the ultrasound-guided and anesthesiologist-administered adductor canal block,” Asim Makhdom, MD, MSc, FRCSC, said of the surgeon-administered adductor canal blocks (ACBs).
Makhdom and his colleagues randomized 23 patients to undergo surgeon-administered ACBs and 28 patients to undergo ultrasound, anesthesiologist-administered ACBs.
The blocks were all done outside of the OR and consisted of a single shot of 15 mL ropivacaine 0.5%, Makhdom said.
The investigators looked at primary outcomes of VAS pain scores, opioid consumption measured in morphine equivalents, patient satisfaction and range of motion on postoperative days 0, 1, 2, 3 and at 6 weeks postoperatively.
“The surgeon-administered adductor canal block is not inferior to ultrasound-guided administered adductor canal block with respect to range of motion, patient satisfaction, opioid consumption and pain relief. The surgeon administration of adductor canal block may have lower VAS pain scores on day 0; however, that did not reach the clinical threshold to be clinically significant,” he said.
“However,” Makhdom said, “this study has some limitations. There’s a possible type 2 error,” he said, which was due to the relatively small number of patients. – by Susan M. Rapp
Greenky MR. Paper 6. Presented at: American Hip and Knee Surgeons Annual Meeting; Nov. 7-10, 2019; Dallas.
Disclosure: Makhdom reports no relevant financial disclosures.