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Similar pain control with adductor canal, femoral nerve blocks for ACL reconstruction
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BOSTON — Patients who undergo ACL reconstruction with an adductor canal nerve block have similar perioperative pain control and narcotic requirements compared to patients who receive femoral nerve block, according to research presented at the American Orthopaedic Society for Sports Medicine Annual Meeting.
“We found noninferior outcomes with use of the adductor nerve block, equivalent pain control at all time points and equivalent ability to perform straight leg raises, as well as equivalent percent thigh circumference postoperatively. Lastly, we found equivalent secondary measures in that patients had equal number of patient phone calls, sleep and surgery satisfaction,” Toufic Raja Jildeh, MD, said.
In the prospective, randomized, double-blinded controlled trial, Jildeah and colleagues studied 60 patients who had primary ACL reconstruction using bone-tendon-bone autograft with a preoperative adductor canal nerve block or a femoral nerve block. Primary outcomes were pain levels and narcotic requirements for 4 postoperative days. Secondary outcomes included the patient’s ability to perform a straight leg raise in the recovery room and difference in thigh circumference between the operative and nonoperative leg 7 days after surgery.
Researchers found that morphine requirements were less for patients who received adductor canal nerve block in the first 4 hours postoperatively. However, there were no other differences between groups for opioid requirements and pain scores after the first 4 hours. Researchers found no differences in patients’ ability to perform a straight leg raise in the recovery room or thigh circumference at the first postoperative visit. – by Kristine Houck, MA, ELS
Reference:
Okoroha KR, et al. Abstract 9. Presented at: American Orthopaedic Society for Sports Medicine Annual Meeting; July 11-14, 2019; Boston.
Disclosure: Jildeh reports no relevant financial disclosures.