Role of adductor canal block and genicular nerve block on postoperative pain and enhanced recovery in patients undergoing total knee arthroplasty: A randomized clinical trial
Abstract Background: The postoperative pain management for total knee arthroplasty (TKA) remains controversial. This work aimed to assess the role of adductor canal block (ACB) and genicular nerve block (GNB) on postoperative pain and the possibility of enhanced recovery in patients undergoing TKA....
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| Format: | Article |
| Language: | English |
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Wolters Kluwer Medknow Publications
2024-04-01
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| Series: | Bali Journal of Anesthesiology |
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| Online Access: | https://doi.org/10.4103/bjoa.bjoa_38_24 |
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| author | Bassel Mohammed Elfokery Mustafa Seet Tareef Ashour Hatem Alharbi Mujeeb Ashraf Hatim Alshareef Mohammad Nyaz Rayan Bakhreba Atif Sait |
| author_facet | Bassel Mohammed Elfokery Mustafa Seet Tareef Ashour Hatem Alharbi Mujeeb Ashraf Hatim Alshareef Mohammad Nyaz Rayan Bakhreba Atif Sait |
| author_sort | Bassel Mohammed Elfokery |
| collection | DOAJ |
| description | Abstract Background: The postoperative pain management for total knee arthroplasty (TKA) remains controversial. This work aimed to assess the role of adductor canal block (ACB) and genicular nerve block (GNB) on postoperative pain and the possibility of enhanced recovery in patients undergoing TKA. Patients and Methods: This randomized trial was conducted on 50 subjects aged 40–75 years who underwent TKA under spinal anesthesia. The patients were divided into two equal groups: group A received an intraarticular injection of 40 mL bupivacaine 0.125% by the surgeon. Group B, in addition to the same intraarticular injection, also received pre-incision GNB (20 mL bupivacaine 0.25% and 8 mg dexamethasone) and ACB (10 mL bupivacaine 0.25% and 4 mg dexamethasone) at the end of surgery. We assessed postoperative pain up to 48 h postoperative, range of motion (ROM), and mobility status. Results: Subjects in group B showed lower Visual Analog Scale at rest and mobilization at 6 h (P < 0.001), 12 h (P = 0.005), 18 h (P = 0.001), and 24 h (P = 0.001). ROM was also significantly higher on postoperative day 1 (P = 0.022) and day 2 (P = 0.007) in group B. Similarly, the ability to walk with support on postoperative day 1 (P = 0.023) and day 2 (P = 0.037) and the ability to perform straight leg raising independently on day 1 (P = 0.038) and day 2 (P = 0.027) days were also notably better in group B. Finally, hospital stay was significantly lower in group B (P = 0.016). Conclusions: The combination of ACB and GNB provided adequate analgesia and enhanced recovery via reducing pain scores, total opioid consumption with shorter hospital stays, better mobility, and patient satisfaction. |
| format | Article |
| id | doaj-art-3bc9642735984f80985e11b1b259b6dd |
| institution | Kabale University |
| issn | 2549-2276 |
| language | English |
| publishDate | 2024-04-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | Bali Journal of Anesthesiology |
| spelling | doaj-art-3bc9642735984f80985e11b1b259b6dd2025-01-25T09:57:50ZengWolters Kluwer Medknow PublicationsBali Journal of Anesthesiology2549-22762024-04-0182828710.4103/bjoa.bjoa_38_24Role of adductor canal block and genicular nerve block on postoperative pain and enhanced recovery in patients undergoing total knee arthroplasty: A randomized clinical trialBassel Mohammed ElfokeryMustafa SeetTareef AshourHatem AlharbiMujeeb AshrafHatim AlshareefMohammad NyazRayan BakhrebaAtif SaitAbstract Background: The postoperative pain management for total knee arthroplasty (TKA) remains controversial. This work aimed to assess the role of adductor canal block (ACB) and genicular nerve block (GNB) on postoperative pain and the possibility of enhanced recovery in patients undergoing TKA. Patients and Methods: This randomized trial was conducted on 50 subjects aged 40–75 years who underwent TKA under spinal anesthesia. The patients were divided into two equal groups: group A received an intraarticular injection of 40 mL bupivacaine 0.125% by the surgeon. Group B, in addition to the same intraarticular injection, also received pre-incision GNB (20 mL bupivacaine 0.25% and 8 mg dexamethasone) and ACB (10 mL bupivacaine 0.25% and 4 mg dexamethasone) at the end of surgery. We assessed postoperative pain up to 48 h postoperative, range of motion (ROM), and mobility status. Results: Subjects in group B showed lower Visual Analog Scale at rest and mobilization at 6 h (P < 0.001), 12 h (P = 0.005), 18 h (P = 0.001), and 24 h (P = 0.001). ROM was also significantly higher on postoperative day 1 (P = 0.022) and day 2 (P = 0.007) in group B. Similarly, the ability to walk with support on postoperative day 1 (P = 0.023) and day 2 (P = 0.037) and the ability to perform straight leg raising independently on day 1 (P = 0.038) and day 2 (P = 0.027) days were also notably better in group B. Finally, hospital stay was significantly lower in group B (P = 0.016). Conclusions: The combination of ACB and GNB provided adequate analgesia and enhanced recovery via reducing pain scores, total opioid consumption with shorter hospital stays, better mobility, and patient satisfaction.https://doi.org/10.4103/bjoa.bjoa_38_24adductor canal blockenhanced recoverygenicular nerve blockspinal anesthesiatotal knee arthroplasty |
| spellingShingle | Bassel Mohammed Elfokery Mustafa Seet Tareef Ashour Hatem Alharbi Mujeeb Ashraf Hatim Alshareef Mohammad Nyaz Rayan Bakhreba Atif Sait Role of adductor canal block and genicular nerve block on postoperative pain and enhanced recovery in patients undergoing total knee arthroplasty: A randomized clinical trial Bali Journal of Anesthesiology adductor canal block enhanced recovery genicular nerve block spinal anesthesia total knee arthroplasty |
| title | Role of adductor canal block and genicular nerve block on postoperative pain and enhanced recovery in patients undergoing total knee arthroplasty: A randomized clinical trial |
| title_full | Role of adductor canal block and genicular nerve block on postoperative pain and enhanced recovery in patients undergoing total knee arthroplasty: A randomized clinical trial |
| title_fullStr | Role of adductor canal block and genicular nerve block on postoperative pain and enhanced recovery in patients undergoing total knee arthroplasty: A randomized clinical trial |
| title_full_unstemmed | Role of adductor canal block and genicular nerve block on postoperative pain and enhanced recovery in patients undergoing total knee arthroplasty: A randomized clinical trial |
| title_short | Role of adductor canal block and genicular nerve block on postoperative pain and enhanced recovery in patients undergoing total knee arthroplasty: A randomized clinical trial |
| title_sort | role of adductor canal block and genicular nerve block on postoperative pain and enhanced recovery in patients undergoing total knee arthroplasty a randomized clinical trial |
| topic | adductor canal block enhanced recovery genicular nerve block spinal anesthesia total knee arthroplasty |
| url | https://doi.org/10.4103/bjoa.bjoa_38_24 |
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