Periarticular Local Infiltrative Anesthesia and Regional Adductor Canal Block Provide Equivalent Pain Relief After Anterior Cruciate Ligament Reconstruction

Andrew L Schaver; Natalie A Glass; Kyle R Duchman; Brian R Wolf; Robert W Westermann

doi:10.1016/j.arthro.2021.10.031

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Periarticular Local Infiltrative Anesthesia and Regional Adductor Canal Block Provide Equivalent Pain Relief After Anterior Cruciate Ligament Reconstruction

Journal article

Open access

Peer reviewed

Periarticular Local Infiltrative Anesthesia and Regional Adductor Canal Block Provide Equivalent Pain Relief After Anterior Cruciate Ligament Reconstruction

Andrew L Schaver, Natalie A Glass, Kyle R Duchman, Brian R Wolf and Robert W Westermann

Arthroscopy, Vol.38(4), pp.1217-1223

04/2022

DOI: 10.1016/j.arthro.2021.10.031

PMID: 34808250

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https://www.ncbi.nlm.nih.gov/pmc/articles/11437521View

Open Access

Abstract

To compare postoperative pain and recovery after anterior cruciate ligament reconstruction (ACLR) in patients who received an adductor canal block (ACB) or periarticular local infiltrative anesthesia (LIA). A retrospective review of a prospectively collected ACL registry was performed. Patients underwent ACLR at a single institution between January 2015 and September 2020 and received long-acting local anesthesia with a preoperative ultrasound-guided ACB or periarticular LIA after surgery. Visual analog scale (VAS) pain scores, milligram morphine equivalents (MME) consumed in the post-anesthesia care unit (PACU), and total hospital recovery time were compared. Univariate analysis was used to compare VAS pain and MME totals between overall groups and groups propensity score matched for age, sex, body mass index, graft type, and meniscal treatment. Results are presented as mean (95%CI) unless otherwise indicated. There were 265 knees (253 patients) included (LIA, 157 knees; ACB, 108 knees). Overall, VAS pain scores before hospital discharge (LIA: 2.6 [2.4-2.8] vs ACB: 2.4 [2.1-2.7]; P = .334) and total MMEs were similar (LIA: 17.6 [16.4-18.8] vs ACB: 18.5 [17.2-19.8] (MME); P =.134). Median time to discharge also did not significantly differ (LIA: 137.5 [IQR: 116-178] vs. ACB: 147 [IQR: 123-183] (min); P = .118). Matched subanalysis (LIA and ACB; n = 94) did not reveal significant differences in VAS pain before discharge (LIA: 2.4 [2.1-2.7] vs ACB: 2.7 [2.4-3.0]; P = .134) or total MMEs (LIA: 18.6 (17.2-20.0) vs ACB: 17.9 (16.4-19.4); P = .520). The use of ACB or LIA resulted in similar early pain levels, opioid consumption, and hospital recovery times after ACLR surgery. III, retrospective comparison study.

Analgesics, Opioid

Anesthesia, Local

Anesthetics, Local

Anterior Cruciate Ligament Reconstruction - methods

Humans

Nerve Block - methods

Pain, Postoperative - drug therapy

Retrospective Studies

Details

Title: Subtitle: Periarticular Local Infiltrative Anesthesia and Regional Adductor Canal Block Provide Equivalent Pain Relief After Anterior Cruciate Ligament Reconstruction
Creators: Andrew L Schaver - University of Iowa
Natalie A Glass - University of Iowa
Kyle R Duchman - University of Iowa
Brian R Wolf - University of Iowa
Robert W Westermann - University of Iowa
Resource Type: Journal article
Publication Details: Arthroscopy, Vol.38(4), pp.1217-1223
DOI: 10.1016/j.arthro.2021.10.031
PMID: 34808250
NLM abbreviation: Arthroscopy
ISSN: 0749-8063
eISSN: 1526-3231
Publisher: Elsevier
Grant note: UL1 TR002537 / NCATS NIH HHS
Language: English
Date published: 04/2022
Academic Unit: Orthopedics and Rehabilitation; Physical Therapy and Rehabilitation Science; Athletic Training Program
Record Identifier: 9984295051602771

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