Comparison of Continuous Adductor Canal Catheters and Single-shot Peripheral Nerve Blocks Providing Analgesia After Unicondylar Knee Replacement, as Part of an Enhanced Recovery After Surgery Program

With the current trend toward ambulatory joint replacements, it is important to identify the approach to postoperative analgesia which best balances comfort and mobility. Adductor canal blocks provide analgesia after unicondylar knee replacement and can be performed with either an infusion catheter [adductor canal block catheter (ACB-C)] or as a single-shot injection [adductor canal block single-shot injection (ACB-SS)]. We conducted a retrospective analysis comparing the perceived quality of analgesia achieved by the 2 techniques, hypothesizing that patients receiving ACB-Cs would have less opioid consumption and lower pain scores than those who received ACB-SSs. After Institutional Review Board approval, we identified patients who underwent unicondylar knee arthroplasty between August and December 2015. Patients designated American Society of Anesthesiologists physical status 1 to 3 were included. Those discharged home on postoperative day (POD) 0 or provided an alternative nerve block were excluded. The primary outcome was opioid consumption over POD 1. Morning and afternoon pain scores were also evaluated. Of the 125 patients identified, there were 17 exclusions. Of those remaining, 69 received an ACB-C and 38 received an ACB-SS. The median amount of opioid use was lower in the ACB-C group than in the ACB-SS group [12 mg (8, 16) vs. 26 mg (20, 31.5), P
Source: Techniques in Orthopaedics - Category: Orthopaedics Tags: Special Technical Articles Source Type: research