Adductor Canal Blockade Following Total Knee Arthroplasty-Continuous or Single Shot Technique? Role in Postoperative Analgesia, Ambulation Ability and Early Functional Recovery: A Randomized Controlled Trial

J Arthroplasty. 2015 Aug;30(8):1476-81. doi: 10.1016/j.arth.2015.03.006. Epub 2015 Mar 16.

Abstract

Total knee arthroplasty (TKA) can be associated with severe pain in early postoperative period. Adductor canal block may provide optimal analgesia following TKA. However, ideal regimen for administration whether continuous or single shot is yet undefined. We prospectively randomized 90 patients in continuous and single shot adductor canal blockade groups. Postoperative VAS (visual analog scale for pain) score was significantly better at all times in continuous than single shot technique (P<0.001). However, ambulation ability (Timed Up & Go, 10m walk, 30s chair) and early functional recovery (active SLR, ambulation with walker, staircase competency, ambulation distance and maximal flexion at discharge) showed no statistical significant difference. Continuous adductor canal blockade was superior to single shot block in terms of pain control but was similar for early functional recovery.

Level of evidence: Level III, therapeutic study.

Keywords: adductor canal block; ambulation ability; analgesia; continuous; single shot; total knee arthroplasty.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Aged
  • Amides / administration & dosage*
  • Anesthetics, Local / administration & dosage*
  • Arthroplasty, Replacement, Knee / rehabilitation*
  • Early Ambulation
  • Female
  • Gait
  • Humans
  • Male
  • Middle Aged
  • Nerve Block / methods*
  • Pain Measurement
  • Pain, Postoperative / drug therapy*
  • Recovery of Function
  • Ropivacaine
  • Treatment Outcome
  • Walking

Substances

  • Amides
  • Anesthetics, Local
  • Ropivacaine