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B300 Comparative study of analgesic efficacy between proximal and distal adductor canal block in patients with unilateral anterior cruciate ligament knee surgery
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  1. NC Yadalla Ramagopal1 and
  2. S Manyam2
  1. 1Cura Hospitals, Bangalore, India
  2. 2Ganga Hospitals, Coimbattore, India

Abstract

Background and Aims Adductor Canal Blocks (ACB), a regional anesthetic technique that aims to introduce local anesthetic to the saphenous nerve as it traverses the adductor canal. By blocking pain pathways while preserving motor innervation, the ACB is an ideal candidate for anterior cruciate ligaments related pain and rehabilitation.The aim of the study is to compare the analgesic efficacy of proximal and distal Adductor Canal Block, as a part of multimodal analgesia, using single shot Bupivacaine for postoperative analgesia, in patients undergoing elective arthroscopic ACL surgeries.

Methods A randomized controlled study was conducted with Sixty patients of ASA Grade 1 and 2, undergoing elective arthroscopic ACL surgeries were randomly divided into two groups, Group A and B. In the postoperative period Group A, received Proximal Adductor canal block, where local anesthetic was injected at the proximal end of the canal and Group B received Distal Adductor canal block, where local anesthetic was injected at the distal end of the canal, using 20 ml of 0.25% Bupivacaine, under ultrasonography guidance. The postoperative pain was assessed by a blinded investigator using 0–10 VAS score at 30 min, 1 hr, 2 hrs, 4 hrs, 6 hrs, 8 hrs and 12 hrs after the blockade.

Results The mean VAS score was more in the group A compared to group B at 6 hrs and 12h which was statistically significant

The mean duration of postoperative analgesia was more in group A than in group B but was not statistically significant

Conclusions Distal Adductor canal bock is superior to proximal as far as VAS score and quality of block are concerned.

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