Background and Aims Lower limb ligament reconstructions can be painful procedures1. Central neuro-axial blocks and some regional techniques are relatively contraindicated as preserving motor function aids rapid patient recovery and same day discharge2. Analgesic techniques vary. The aim of the audit was to achieve a snapshot survey of current practice and relevant outcomes.
Methods With approval from the audit team the theatre database was searched for relevant procedures between April 2019 and March 2020. 97 cases were identified, of which 74 case notes were analysed. The following features were audited: anaesthetic time, theatre time, ASA, demographics, chronic pain history, anaesthetic technique, post-op pain, morphine requirements, antiemetic requirements and length of stay.
Results 95.9% of cases involved general anaesthesia and 4.1% spinal anaesthesia. 56.8% received no nerve block, 39.2% received an adductor canal block and 4.1% received a femoral nerve block. Mild/no pain was reported by 61.5% of patients without a nerve block and by 71.9% who did receive a nerve block. Patients who received a nerve block required less morphine within the first 24 hours (9.7mg vs 12.4mg) and less antiemetic therapy (16% vs 23%).
Patients who received a block had a longer length of stay (25.9 hours vs 19.4 hours).
Conclusions Just under half of cases received a nerve block. The use of adductor canal block is associated with modestly reduced post-op pain and consequently reduced morphine requirements and post-operative nausea. Adductor canal blocks are associated with increased length of stay. Patients were not randomised between techniques so differences in outcomes could be due to confounding factors.
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