Application of ultrasound-guided single femoral triangle and adductor canal block in arthroscopic knee surgery: a prospective, double-blind, randomized clinical study.
Humans
Arthroscopy
/ methods
Male
Female
Double-Blind Method
Prospective Studies
Ultrasonography, Interventional
/ methods
Middle Aged
Nerve Block
/ methods
Pain, Postoperative
/ prevention & control
Adult
Femoral Nerve
/ drug effects
Ropivacaine
/ administration & dosage
Anesthetics, Local
/ administration & dosage
Muscle Strength
/ drug effects
Quadriceps Muscle
Knee Joint
/ surgery
Analgesia
Arthroscopic surgery
Humans
Knee
Nerve block
Pain
Postoperative pain
Journal
BMC anesthesiology
ISSN: 1471-2253
Titre abrégé: BMC Anesthesiol
Pays: England
ID NLM: 100968535
Informations de publication
Date de publication:
23 May 2024
23 May 2024
Historique:
received:
22
03
2024
accepted:
06
05
2024
medline:
24
5
2024
pubmed:
24
5
2024
entrez:
23
5
2024
Statut:
epublish
Résumé
To compare the difference in analgesic effect between femoral triangle block (FTB) and adductor canal block (ACB) during arthroscopic knee surgery. Patients who underwent arthroscopic knee surgery were randomized preoperatively to FTB group or ACB group. For each group, 20 mL of 0.1% ropivacaine was injected. The numeric rating score (NRS) at 12 h after surgery at rest and during movement. (1) The NRS at post anesthesia care unit (PACU) and 2, 24 h after surgery at rest and during movement; (2) The quadriceps muscle strength at PACU and 2, 12, 24 h after surgery; (3) Consumption of Rescue analgesia; (4) Incidence of adverse reactions. The NRS at 12 h after surgery at rest and during movement of ACB group were higher than FTB group. Among secondary outcomes, the NRS at PACU at rest and during movement, 2 h after surgery during movement of FTB group lower than ACB group; the quadriceps muscle strength at 2 h after surgery of FTB group stronger than ACB group. After multiple linear regression model analysis, the data showed additional statistically significant reduction NRS at 24 h after surgery at rest (0.757, p = 0.037) in FTB group. Other outcomes were similar between two groups. The FTB appears to provide superior pain control after knee arthroscopy than ACB, the FTB is superior to the ACB in quadriceps muscle strength at 2 h after surgery. The trial was registered in the Chinese Clinical Trial Registry (ChiCTR2300068765). Registration date: 28/02/2023.
Identifiants
pubmed: 38783177
doi: 10.1186/s12871-024-02555-0
pii: 10.1186/s12871-024-02555-0
doi:
Substances chimiques
Ropivacaine
7IO5LYA57N
Anesthetics, Local
0
Types de publication
Journal Article
Randomized Controlled Trial
Langues
eng
Sous-ensembles de citation
IM
Pagination
182Subventions
Organisme : Future Medical Youth Innovation Team Development Support Program of Chongqing Medical University
ID : W0004
Organisme : Chongqing Municipal Public Health Bureau, Chongqing People's Municipal Government
ID : 2022WSJK117
Informations de copyright
© 2024. The Author(s).
Références
Moeen SM, Ramadan IK, Elkady HA. Dexamethasone and Dexmedetomidine as an adjuvant to Intraarticular Bupivacaine for Postoperative Pain relief in knee arthroscopic surgery: a Randomized Trial. Pain Physician. 2017;20(7):671–80.
doi: 10.36076/ppj/2017.7.671
pubmed: 29149146
Hussain N, Brull R, Vannabouathong C, Speer J, Lagnese C, McCartney CJL, Abdallah FW. Network meta-analysis of the analgesic effectiveness of regional anaesthesia techniques for anterior cruciate ligament reconstruction. Anaesthesia. 2023;78(2):207–24.
doi: 10.1111/anae.15873
pubmed: 36326047
Hurley ET, Danilkowicz RM, Toth AP. Editorial Commentary: postoperative Pain Management after Anterior Cruciate Ligament Reconstruction can minimize opioid use and allow early Rehabilitation. Arthroscopy. 2023;39(5):1296–8.
doi: 10.1016/j.arthro.2023.01.018
pubmed: 37019539
Anderson TA. The Opioid Wars-CON: the risks of opioids for Pain Management Outweigh the benefits. Clin J Pain. 2019;35(6):463–7.
doi: 10.1097/AJP.0000000000000702
pubmed: 30985394
Perry M, LeDuc R, Stakenas S, Wozniak A, Francois A, Evans D. Adductor Canal nerve block versus intra-articular anesthetic in knee arthroscopy: a single-blinded prospective Randomized Trial. J Knee Surg 2023.
Hanson NA, Derby RE, Auyong DB, Salinas FV, Delucca C, Nagy R, Yu Z, Slee AE. Ultrasound-guided adductor canal block for arthroscopic medial meniscectomy: a randomized, double-blind trial. Can J Anaesth. 2013;60(9):874–80.
doi: 10.1007/s12630-013-9992-9
pubmed: 23820968
Fan Chiang YH, Wang MT, Chan SM, Chen SY, Wang ML, Hou JD, Tsai HC, Lin JA. Motor-Sparing Effect of Adductor Canal Block for knee analgesia: an Updated Review and a subgroup analysis of randomized controlled trials based on a corrected classification system. Healthc (Basel) 2023, 11(2).
Jaeger P, Nielsen ZJ, Henningsen MH, Hilsted KL, Mathiesen O, Dahl JB. Adductor canal block versus femoral nerve block and quadriceps strength: a randomized, double-blind, placebo-controlled, crossover study in healthy volunteers. Anesthesiology. 2013;118(2):409–15.
doi: 10.1097/ALN.0b013e318279fa0b
pubmed: 23241723
Meier AW, Auyong DB, Yuan SC, Lin SE, Flaherty JM, Hanson NA. Comparison of continuous proximal Versus Distal Adductor Canal blocks for total knee arthroplasty: a Randomized, Double-Blind, Noninferiority Trial. Reg Anesth Pain Med. 2018;43(1):36–42.
doi: 10.1097/AAP.0000000000000692
pubmed: 29140959
Sztain JF, Khatibi B, Monahan AM, Said ET, Abramson WB, Gabriel RA, Finneran JJt, Bellars RH, Nguyen PL, Ball ST, et al. Proximal Versus Distal continuous Adductor Canal blocks: does varying Perineural Catheter Location Influence Analgesia? A Randomized, Subject-Masked, controlled clinical trial. Anesth Analg. 2018;127(1):240–6.
doi: 10.1213/ANE.0000000000003422
pubmed: 29750695
Layera S, Saadawi M, Tran Q, Salinas FV. Motor-sparing peripheral nerve blocks for shoulder, knee, and hip surgery. Adv Anesth. 2020;38:189–207.
doi: 10.1016/j.aan.2020.08.003
pubmed: 34106834
Woodworth GE, Arner A, Nelsen S, Nada E, Elkassabany NM. Pro and con: how important is the exact location of Adductor Canal and femoral triangle blocks? Anesth Analg. 2023;136(3):458–69.
doi: 10.1213/ANE.0000000000006234
pubmed: 36806233
Runge C, Moriggl B, Børglum J, Bendtsen TF. The spread of Ultrasound-guided Injectate from the Adductor Canal to the Genicular Branch of the posterior obturator nerve and the Popliteal Plexus: a cadaveric study. Reg Anesth Pain Med. 2017;42(6):725–30.
doi: 10.1097/AAP.0000000000000675
pubmed: 28937534
Alghadir AH, Anwer S, Iqbal A, Iqbal ZA. Test-retest reliability, validity, and minimum detectable change of visual analog, numerical rating, and verbal rating scales for measurement of osteoarthritic knee pain. J Pain Res. 2018;11:851–6.
doi: 10.2147/JPR.S158847
pubmed: 29731662
pmcid: 5927184
Lee B, Park SJ, Park KK, Kim HJ, Lee YS, Choi YS. Optimal location for continuous catheter analgesia among the femoral triangle, proximal, or distal adductor canal after total knee arthroplasty: a randomized double-blind controlled trial. Reg Anesth Pain Med. 2022;47(6):353–8.
doi: 10.1136/rapm-2021-103284
pubmed: 35173020
Wang CG, Ding YL, Wang YY, Liu JY, Zhang Q. Comparison of Adductor Canal Block and Femoral Triangle Block for Total Knee Arthroplasty. Clin J Pain. 2020;36(7):558–61.
doi: 10.1097/AJP.0000000000000833
pubmed: 32271182
Goffin P, Lecoq JP, Ninane V, Brichant JF, Sala-Blanch X, Gautier PE, Bonnet P, Carlier A, Hadzic A. Interfascial Spread of Injectate after Adductor Canal Injection in Fresh Human cadavers. Anesth Analg. 2016;123(2):501–3.
doi: 10.1213/ANE.0000000000001441
pubmed: 27442773
Gautier PE, Hadzic A, Lecoq JP, Brichant JF, Kuroda MM, Vandepitte C. Distribution of Injectate and sensory-motor Blockade after Adductor Canal Block. Anesth Analg. 2016;122(1):279–82.
doi: 10.1213/ANE.0000000000001025
pubmed: 26678473
Gautier PE, Lecoq JP, Vandepitte C, Harstein G, Brichant JF. Impairment of sciatic nerve function during adductor canal block. Reg Anesth Pain Med. 2015;40(1):85–9.
doi: 10.1097/AAP.0000000000000180
pubmed: 25503350
Abdallah FW, Brull R, Joshi GP, Society for Ambulatory A. Pain Management for Ambulatory Arthroscopic Anterior Cruciate Ligament Reconstruction: evidence-based recommendations from the Society for Ambulatory Anesthesia. Anesth Analg. 2019;128(4):631–40.
doi: 10.1213/ANE.0000000000003976
pubmed: 30649069
Holbert SE, Baxter SN, Brennan JC, Johnson AH, Cheema M, Turcotte JJ, MacDonald JH, King PJ. Adductor Canal blocks are not Associated with Improved Early postoperative outcomes in patients undergoing total knee arthroplasty. Ochsner J. 2023;23(1):9–15.
doi: 10.31486/toj.22.0074
pubmed: 36936480
pmcid: 10016221
Panchamia JK, Niesen AD, Amundson AW. Adductor Canal Versus femoral triangle: let us all get on the same page. Anesth Analg. 2018;127(3):e50.
doi: 10.1213/ANE.0000000000003570
pubmed: 29905612
Nada E, Elmansoury A, Elkassabany N, Whitney ER. Location of the entry point of the muscular branch of the nerve to vastus medialis. Br J Anaesth. 2021;127(2):e58–60.
doi: 10.1016/j.bja.2021.04.027
pubmed: 34092383
Sonawane K, Dixit H, Mistry T, Gurumoorthi P. A high-volume proximal adductor canal (Hi-PAC) block - an indirect anterior approach of the popliteal sciatic nerve block. J Clin Anesth. 2021;73:110348.
doi: 10.1016/j.jclinane.2021.110348
pubmed: 34062476
Pascarella G, Costa F, Del Buono R, Strumia A, Agro FE. Adductor canal or femoral triangle block: not a conundrum but a continuum. Comment on Br J Anaesth 2020; 124: e194-5. Br J Anaesth 2020, 125(2):e233-e234.
Jæger P, Jenstrup MT, Lund J, Siersma V, Brøndum V, Hilsted KL, Dahl JB. Optimal volume of local anaesthetic for adductor canal block: using the continual reassessment method to estimate ED95. Br J Anaesth. 2015;115(6):920–6.
doi: 10.1093/bja/aev362
pubmed: 26582853
Martin R, Kirkham KR, Ngo THN, Gonvers E, Lambert J, Albrecht E. Combination of femoral triangle block and infiltration between the popliteal artery and the capsule of the posterior knee (iPACK) versus local infiltration analgesia for analgesia after anterior cruciate ligament reconstruction: a randomized controlled triple-blinded trial. Reg Anesth Pain Med. 2021;46(9):763–8.
doi: 10.1136/rapm-2021-102631
pubmed: 34039734
Ohgoshi Y, Matsutani M, Kubo EN. Use of IPACK block with continuous femoral triangle block for total knee arthroplasty: a clinical experience. J Clin Anesth. 2019;54:52–4.
doi: 10.1016/j.jclinane.2018.10.045
pubmed: 30391457
Song L, Li Y, Xu Z, Geng ZY, Wang DX. Comparison of the ultrasound-guided single-injection femoral triangle block versus adductor canal block for analgesia following total knee arthroplasty: a randomized, double-blind trial. J Anesth. 2020;34(5):702–11.
doi: 10.1007/s00540-020-02813-8
pubmed: 32533332
Ogura T, Omatsu H, Fukuda H, Asai S, Saito C, Takahashi T, Ichino Y, Omodani T, Sakai H, Yamaura I, et al. Femoral nerve versus adductor canal block for early postoperative pain control and knee function after anterior cruciate ligament reconstruction with hamstring autografts: a prospective single-blind randomised controlled trial. Arch Orthop Trauma Surg. 2021;141(11):1927–34.
doi: 10.1007/s00402-021-03823-1
pubmed: 33609182