Takahiro Ogura1,2, Hiroaki Omatsu3, Hideaki Fukuda4, Shigehiro Asai4, Chikara Saito4, Tatsuya Takahashi4, Yoshinobu Ichino4, Toru Omodani4, Hiroki Sakai4, Ichiro Yamaura4, Yohei Kawasaki5, Akihiro Tsuchiya4, Kenji Takahashi4. 1. Sports Medicine and Joint Center, Funabashi Orthopaedic Hospital, 1-833 Hasama, Funabashi, Chiba, 274-0822, Japan. togura@fff.or.jp. 2. Musculoskeletal Pain and Disease, Center for Preventive Medical Sciences, School of Medicine, Chiba University, 1-8-1, Inohana, Chiba, 260-8677, Japan. togura@fff.or.jp. 3. Funabashi Orthopaedic Hospital, 1-833 Hasama, Funabashi, Chiba, 274-0822, Japan. 4. Sports Medicine and Joint Center, Funabashi Orthopaedic Hospital, 1-833 Hasama, Funabashi, Chiba, 274-0822, Japan. 5. Biostatistics Section, Clinical Research Center, Chiba University Hospital, 1-8-1, Inohana, Chiba, 260-8677, Japan.
Abstract
INTRODUCTION: The optimal pain management strategy for postoperative pain after anterior cruciate ligament reconstruction (ACLR) remains unclear. This study compared femoral nerve block (FNB) and adductor canal block (ACB) for pain management of early postoperative pain, knee function, and recovery of activity of daily living (ADL) after ACLR using hamstring autografts. MATERIAL AND METHODS: In this prospective, single-blind, randomised controlled trial, 64 patients aged 12-56 years who underwent anatomical double-bundle ACLR with a hamstring autograft between August 2019 and May 2020 were randomised to undergo preoperative FNB (n = 32) or ACB (n = 32). The peripheral nerve block was performed by a single experienced anaesthesiologist under ultrasound guidance. The primary outcomes were postoperative pain as evaluated using the visual analogue scale (VAS) at 3, 6, 12, 24, and 48 h postoperatively and the need for pain relief. The secondary outcome was knee function, including the recovery of range of motion, contraction of the vastus medialis, and stable walking with a double-crutch (ADL), as evaluated by blinded physical therapists. RESULTS: There were no significant differences in patient demographics between the two groups. The VAS scores, need for pain relief, knee function, and ADL did not significantly differ between the groups. CONCLUSION:FNB and ACB provided comparable outcomes related to early postoperative pain, knee function, and ADL after double-bundle ACLR using hamstring autografts. Further research is necessary to evaluate the mid- to long-term effect of each block on recovery of knee function and ADL. LEVEL OF EVIDENCE: I.
RCT Entities:
INTRODUCTION: The optimal pain management strategy for postoperative pain after anterior cruciate ligament reconstruction (ACLR) remains unclear. This study compared femoral nerve block (FNB) and adductor canal block (ACB) for pain management of early postoperative pain, knee function, and recovery of activity of daily living (ADL) after ACLR using hamstring autografts. MATERIAL AND METHODS: In this prospective, single-blind, randomised controlled trial, 64 patients aged 12-56 years who underwent anatomical double-bundle ACLR with a hamstring autograft between August 2019 and May 2020 were randomised to undergo preoperative FNB (n = 32) or ACB (n = 32). The peripheral nerve block was performed by a single experienced anaesthesiologist under ultrasound guidance. The primary outcomes were postoperative pain as evaluated using the visual analogue scale (VAS) at 3, 6, 12, 24, and 48 h postoperatively and the need for pain relief. The secondary outcome was knee function, including the recovery of range of motion, contraction of the vastus medialis, and stable walking with a double-crutch (ADL), as evaluated by blinded physical therapists. RESULTS: There were no significant differences in patient demographics between the two groups. The VAS scores, need for pain relief, knee function, and ADL did not significantly differ between the groups. CONCLUSION:FNB and ACB provided comparable outcomes related to early postoperative pain, knee function, and ADL after double-bundle ACLR using hamstring autografts. Further research is necessary to evaluate the mid- to long-term effect of each block on recovery of knee function and ADL. LEVEL OF EVIDENCE: I.
Authors: Lane Bailey; Joshua Griffin; Mark Elliott; Jennifer Wu; Thanos Papavasiliou; Christopher Harner; Walter Lowe Journal: Arthroscopy Date: 2019-02-04 Impact factor: 4.772
Authors: Faraj W Abdallah; Daniel B Whelan; Vincent W Chan; Govindarajulu A Prasad; Ryan V Endersby; John Theodoropolous; Stephanie Oldfield; Justin Oh; Richard Brull Journal: Anesthesiology Date: 2016-05 Impact factor: 7.892