BACKGROUND: Multimodal analgesia, including peripheral nerve blocks, is recommended for postoperative pain reliefafter total knee arthroplasty (TKA). To date, no randomized controlled trial has compared the efficacy of adductor canal catheters (ACCs) and intraarticular catheters (IACs) in patients undergoing TKA. METHODS: A prospective, randomized control trial was performed in 96 primary, unilateral TKA patients comparing ACC with IAC between April, 2014 and August, 2015. Primary outcome measured was numeric pain scores before and after the first physical therapy session on postoperative day 1. Secondary outcomes were oxycodone consumption at 24 and 48 hours, total opioid consumption in morphine equivalents at 24 and 48 hours, active and passive range of motion during physical therapy, patient satisfaction, and length of stay. RESULTS: Results demonstrated that the ACC provided significantly better pain control on postoperative day 1 (P = .02) compared with the IAC. ACC trended toward significantly reduced oxycodone consumption at 24 hours postoperatively compared to IAC (25.64 vs 34.67 mg, P = .057). However, total opioid consumption was equivalent between the groups at 24 hours (32.24 vs 38.55 P = .185) or 48 hours (45.2 vs 52.0, P = .330). CONCLUSION:ACC should be considered as part of a multimodal pain regimen after primary, unilateral TKA and provides a better option for pain control after discharge.
RCT Entities:
BACKGROUND: Multimodal analgesia, including peripheral nerve blocks, is recommended for postoperative pain relief after total knee arthroplasty (TKA). To date, no randomized controlled trial has compared the efficacy of adductor canal catheters (ACCs) and intraarticular catheters (IACs) in patients undergoing TKA. METHODS: A prospective, randomized control trial was performed in 96 primary, unilateral TKA patients comparing ACC with IAC between April, 2014 and August, 2015. Primary outcome measured was numeric pain scores before and after the first physical therapy session on postoperative day 1. Secondary outcomes were oxycodone consumption at 24 and 48 hours, total opioid consumption in morphine equivalents at 24 and 48 hours, active and passive range of motion during physical therapy, patient satisfaction, and length of stay. RESULTS: Results demonstrated that the ACC provided significantly better pain control on postoperative day 1 (P = .02) compared with the IAC. ACC trended toward significantly reduced oxycodone consumption at 24 hours postoperatively compared to IAC (25.64 vs 34.67 mg, P = .057). However, total opioid consumption was equivalent between the groups at 24 hours (32.24 vs 38.55 P = .185) or 48 hours (45.2 vs 52.0, P = .330). CONCLUSION:ACC should be considered as part of a multimodal pain regimen after primary, unilateral TKA and provides a better option for pain control after discharge.
Authors: Alexander Schnabel; Sylvia U Reichl; Stephanie Weibel; Peter K Zahn; Peter Kranke; Esther Pogatzki-Zahn; Christine H Meyer-Frießem Journal: Cochrane Database Syst Rev Date: 2019-10-26
Authors: Kushal Hippalgaonkar; Vivek Chandak; Deepesh Daultani; Praharsha Mulpur; Krishna Kiran Eachempati; A V Gurava Reddy Journal: Bone Jt Open Date: 2021-12