S R Sankineani1, A R C Reddy2, K S Ajith Kumar3, K K Eachempati4, A V G Reddy5. 1. Department of Orthopaedics, Sunshine Hospital, P.G. Road, Secunderabad, Telangana, India. sukeshrao.sankineni@gmail.com. 2. Department of Anaesthesia, Mediciti Institute of Medical Sciences, Medchal, Hyderabad, India. 3. Department of Orthopaedics, Hassan Institute of Medical Sciences, Hassan, Karnataka, India. 4. Department of Orthopaedics, Maxcure Hospital, Madhapur, Hyderabad, Telangana, India. 5. Department of Orthopaedics, Sunshine Hospital, P.G. Road, Secunderabad, Telangana, India.
Abstract
PURPOSE: Pain management after total knee arthroplasty has seen many recent advances such as peripheral nerve blocks in order to improve the functional outcome and reduce morbidity after surgery. Adductor canal block (ACB) and multimodal periarticular infiltration (MPI) are two techniques that have been proven to be efficacious individually. We hypothesized that the combination of ACB with MPI would reduce pain and improve knee range of movement (ROM) compared to ACB alone. METHODS: A prospective non-randomized study was conducted from July 2015 to December 2015 in our institution in a total of 200 consecutive patients undergoing unilateral total knee arthroplasty who were either given ACB alone (Group 1, n = 100 patients) or ACB + MPI (Group 2, n = 100 patients). All the patients were assessed for severity of pain by Visual Analogue Scale (VAS) at 8, 24, 48 h postoperatively and knee ROM after 48 h. RESULTS: Patients in ACB + MPI group had significantly better VAS scores at 8 h postoperatively but showed no significant difference at 24 and 48 h compared to ACB group. Patients in ACB + MPI group showed significantly better knee ROM after 48 h. CONCLUSIONS: Our study concludes that patients receiving ACB + MPI have demonstrated better VAS scores in the immediate postoperative period but have no significant difference at the time of discharge.
PURPOSE:Pain management after total knee arthroplasty has seen many recent advances such as peripheral nerve blocks in order to improve the functional outcome and reduce morbidity after surgery. Adductor canal block (ACB) and multimodal periarticular infiltration (MPI) are two techniques that have been proven to be efficacious individually. We hypothesized that the combination of ACB with MPI would reduce pain and improve knee range of movement (ROM) compared to ACB alone. METHODS: A prospective non-randomized study was conducted from July 2015 to December 2015 in our institution in a total of 200 consecutive patients undergoing unilateral total knee arthroplasty who were either given ACB alone (Group 1, n = 100 patients) or ACB + MPI (Group 2, n = 100 patients). All the patients were assessed for severity of pain by Visual Analogue Scale (VAS) at 8, 24, 48 h postoperatively and knee ROM after 48 h. RESULTS:Patients in ACB + MPI group had significantly better VAS scores at 8 h postoperatively but showed no significant difference at 24 and 48 h compared to ACB group. Patients in ACB + MPI group showed significantly better knee ROM after 48 h. CONCLUSIONS: Our study concludes that patients receiving ACB + MPI have demonstrated better VAS scores in the immediate postoperative period but have no significant difference at the time of discharge.
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