The efficacy of adductor canal blockade after minor arthroscopic knee surgery - a randomised controlled trial

• Published in: Acta anaesthesiologica Scandinavica Vol. 58; no. 3; pp. 273 - 280
• Main Authors: ESPELUND, M., FOMSGAARD, J. S., HARASZUK, J., DAHL, J. B., MATHIESEN, O.
• Format: Journal Article
• Language: English
• Published: England Blackwell Publishing Ltd 01.03.2014; Wiley Subscription Services, Inc
• Subjects: Adolescent; Adult; Aged; Ambulatory Surgical Procedures; Amides; Analgesics; Analgesics, Opioid - administration & dosage; Analgesics, Opioid - therapeutic use; Anesthetics, Local; Arthroscopy; Confidence intervals; Double-Blind Method; Female; Humans; Knee; Knee - surgery; Male; Middle Aged; Nerve Block - adverse effects; Nerve Block - methods; Pain; Pain Measurement; Pain, Postoperative - drug therapy; Postoperative Nausea and Vomiting - epidemiology; Surgery; Thigh - innervation; Treatment Outcome; Young Adult
• ISSN: 0001-5172; 1399-6576
• DOI: 10.1111/aas.12224

Background Adductor canal blockade (ACB) has been demonstrated to be effective in the treatment of post‐operative pain after major knee surgery. We hypothesised that the ACB would reduce pain and analgesic requirements after minor arthroscopic knee surgery. Methods Seventy‐two patients scheduled for minor knee surgery were enrolled in this placebo‐controlled, blinded trial. The patients were randomised to receive an ACB with either 30 ml ropivacaine 7.5 mg/ml (n = 36) or saline (n = 35) in addition to a basic analgesic regimen with paracetamol and ibuprofen. Primary outcome measure was pain during standing at 2 h after surgery. Secondary outcomes were pain at rest, while standing and after a 5‐m walk; opioid consumption and opioid‐related side effects 0–24 h after surgery. Results Pain scores {median [interquartile range (IQR)]}, regarding primary outcome were 15 (0–26) mm in the ropivacaine vs. 17 (5–28) mm in the control group, 95% confidence interval (CI) (−10 to 4) mm, P = 0.41. Ketobemidone consumption 0–2 h post‐operatively [median (IQR)] was lower in the ropivacaine vs. the control group: 0.0 (0.0–2.5) mg vs. 2.5 (0.0–5.0) mg, 95% CI: −2.5 to 0 mg, P = 0.01. No differences were observed for any other outcome. Conclusion No significant analgesic effect of the ACB could be detected after minor arthroscopic knee surgery with a basic analgesic regimen with acetaminophen and ibuprofen, except from a minor reduction in immediate requirements for supplemental opioids. Clinicaltrials.gov Identifier: NCT01254825.