Ming-Jie Kuang1, Li-Yan Xu2, Jian-Xiong Ma3, Ying Wang4, Jie Zhao5, Bin Lu6, Xin-Long Ma7. 1. Biomechanics Labs of Orthopaedics Institute, Tianjin Hospital, Tianjin 300050, People's Republic of China; Tianjin Medical University, Tianjin 300070, People's Republic of China. Electronic address: 2009021106@tmu.edu.cn. 2. Biomechanics Labs of Orthopaedics Institute, Tianjin Hospital, Tianjin 300050, People's Republic of China; Tianjin Medical University, Tianjin 300070, People's Republic of China. Electronic address: xlyan0911@163.com. 3. Biomechanics Labs of Orthopaedics Institute, Tianjin Hospital, Tianjin 300050, People's Republic of China. Electronic address: icedoc@126.com. 4. Biomechanics Labs of Orthopaedics Institute, Tianjin Hospital, Tianjin 300050, People's Republic of China. Electronic address: 297286061@qq.com. 5. Biomechanics Labs of Orthopaedics Institute, Tianjin Hospital, Tianjin 300050, People's Republic of China; Tianjin Medical University, Tianjin 300070, People's Republic of China. Electronic address: zhaojiekoulan@163.com. 6. Biomechanics Labs of Orthopaedics Institute, Tianjin Hospital, Tianjin 300050, People's Republic of China. Electronic address: 578794145@qq.com. 7. Biomechanics Labs of Orthopaedics Institute, Tianjin Hospital, Tianjin 300050, People's Republic of China; Department of Orthopedics, Tianjin Hospital, Tianjin 300211, People's Republic of China. Electronic address: maxinlong8686@126.com.
Abstract
OBJECTIVE: Continuous femoral nerve block (CFNB) is considered the preferred analgesia after TKA. However, it may weaken quadriceps muscle strength, subsequently increasing the risk of falling. Adductor canal block (ACB) is a new sensory block technique that effectively relieves postoperative pain while preserving quadriceps strength. Thias meta-analysis was conducted to determine whether ACB of CFNB provides better pain relief and functional recovery after TKA. METHOD: The PubMed, Embase, Web of Science and Cochrane Library databases were comprehensively searched. Seven studies comparing ACB with CFNB in patients with TKA were enrolled in our meta-analysis. Review Manager 5.3 for Windows was used to analyse the extracted data. RESULTS: Compared with the CFNB group, the ACB exhibited a significant decrease in visual analogue scale (VAS) score at rest within 24 h (p < 0.00001), as well as significant decreases in the length of hospital stay (P < 0.0001) and post-operative nausea (P = 0.03). ACB patients also exhibited greater improvements in ambulation ability (P = 0.01) and ambulation distance (P < 0.00001). There were no significant differences in the VAS score at rest 8 and 48 h following surgery, nor in the ambulation VAS score and opioid consumption two days following surgery. CONCLUSIONS: Compared with CFNB, ACB provides equally effective analgesia after TKA. ACB results in fast pain relief and early ambulation while decreasing post-operative nausea. ACB thus has the potential to replace CFNB as the gold standard for pain management in TKA patients.
OBJECTIVE:Continuous femoral nerve block (CFNB) is considered the preferred analgesia after TKA. However, it may weaken quadriceps muscle strength, subsequently increasing the risk of falling. Adductor canal block (ACB) is a new sensory block technique that effectively relieves postoperative pain while preserving quadriceps strength. Thias meta-analysis was conducted to determine whether ACB of CFNB provides better pain relief and functional recovery after TKA. METHOD: The PubMed, Embase, Web of Science and Cochrane Library databases were comprehensively searched. Seven studies comparing ACB with CFNB in patients with TKA were enrolled in our meta-analysis. Review Manager 5.3 for Windows was used to analyse the extracted data. RESULTS: Compared with the CFNB group, the ACB exhibited a significant decrease in visual analogue scale (VAS) score at rest within 24 h (p < 0.00001), as well as significant decreases in the length of hospital stay (P < 0.0001) and post-operative nausea (P = 0.03). ACBpatients also exhibited greater improvements in ambulation ability (P = 0.01) and ambulation distance (P < 0.00001). There were no significant differences in the VAS score at rest 8 and 48 h following surgery, nor in the ambulation VAS score and opioid consumption two days following surgery. CONCLUSIONS: Compared with CFNB, ACB provides equally effective analgesia after TKA. ACB results in fast pain relief and early ambulation while decreasing post-operative nausea. ACB thus has the potential to replace CFNB as the gold standard for pain management in TKA patients.
Authors: Fabio A Rodriguez-Patarroyo; Nadin Cuello; Robert Molloy; Viktor Krebs; Alparslan Turan; Nicholas S Piuzzi Journal: EFORT Open Rev Date: 2021-12-10
Authors: Ryan R Thacher; Thomas R Hickernell; Matthew J Grosso; Roshan Shah; Herbert J Cooper; Robert Maniker; Anthony Robin Brown; Jeffrey Geller Journal: Arthroplast Today Date: 2017-04-15