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Adductor Canal—Saphenous Block

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https://www.readbyqxmd.com/read/29140959/comparison-of-continuous-proximal-versus-distal-adductor-canal-blocks-for-total-knee-arthroplasty-a-randomized-double-blind-noninferiority-trial
#1
Adam W Meier, David B Auyong, Stanley C Yuan, Shin-E Lin, James M Flaherty, Neil A Hanson
BACKGROUND AND OBJECTIVES: Adductor canal blocks (ACBs) are associated with improved analgesia, preserved quadriceps strength, and decreased length of hospitalization after total knee arthroplasty (TKA). However, controversy remains regarding the ideal location of a continuous block within the adductor canal, and it remains unclear whether similar clinical benefits are obtained irrespective of block location. In this randomized, double-blind, noninferiority study, we hypothesized that a continuous proximal ACB provides postoperative analgesia that is no worse than a continuous distal ACB...
November 14, 2017: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/29064877/evidence-basis-for-regional-anesthesia-in-ambulatory-arthroscopic-knee-surgery-and-anterior-cruciate-ligament-reconstruction-part-ii-adductor-canal-nerve-block-a-systematic-review-and-meta-analysis
#2
Herman Sehmbi, Richard Brull, Ushma Jitendra Shah, Kariem El-Boghdadly, David Nguyen, Girish P Joshi, Faraj W Abdallah
BACKGROUND: Adductor canal block (ACB) has emerged as an effective analgesic regional technique for major knee surgeries in the last decade. Its motor-sparing properties make it particularly attractive for ambulatory knee surgery, but evidence supporting its use in ambulatory arthroscopic knee surgery is conflicting. This systematic review and meta-analysis evaluates the analgesic effects of ACB for ambulatory arthroscopic knee surgeries. METHODS: We conducted a comprehensive search of electronic databases for randomized controlled trials examining the analgesic effects of ACB compared to control or any other analgesic modality...
October 19, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29043004/efficacy-of-perineural-dexamethasone-with-ropivacaine-in-adductor-canal-block-for-post-operative-analgesia-in-patients-undergoing-total-knee-arthroplasty-a-randomized-controlled-trial
#3
Cun-Jin Wang, Feng-Yun Long, Liu-Qing Yang, You-Jing Shen, Fang Guo, Tian-Feng Huang, Ju Gao
Adductor canal block (ACB) is an effective analgesic alternative to femoral nerve block after total knee arthroplasty (TKA). The aim of the present study was to investigate whether addition of dexamethasone to ropivacaine for ACB is able to prolong analgesia and reduce pain. Study participants were randomized into groups receiving ACB with either 0.5% ropivacaine + normal saline (control group; n=93) or 0.5% ropivacaine + 8 mg dexamethasone (dexamethasone group; n=93). All patients were subjected to identical peri-operative management...
October 2017: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/29026354/novel-regional-techniques-for-total-knee-arthroplasty-promote-reduced-hospital-length-of-stay-an-analysis-of-106-patients
#4
Salman Thobhani, Lauren Scalercio, Clint E Elliott, Bobby D Nossaman, Leslie C Thomas, Dane Yuratich, Kim Bland, Kristie Osteen, Matthew E Patterson
BACKGROUND: Novel regional techniques, including the adductor canal block (ACB) and the local anesthetic infiltration between the popliteal artery and capsule of the knee (IPACK) block, provide an alternative approach for controlling pain following total knee arthroplasty (TKA). This study compared 3 regional techniques (femoral nerve catheter [FNC] block alone, FNC block with IPACK, and ACB with IPACK) on pain scores, opioid consumption, performance during physical therapy, and hospital length of stay in patients undergoing TKA...
2017: Ochsner Journal
https://www.readbyqxmd.com/read/28991061/determination-of-ed50-and-ed95-of-0-5-ropivacaine-in-adductor-canal-block-to-produce-quadriceps-weakness-a-dose-finding-study
#5
David F Johnston, Rakesh V Sondekoppam, Robert Giffin, Robert Litchfield, Sugantha Ganapathy
BACKGROUND AND OBJECTIVES: Adductor canal block (ACB) is popular for knee analgesia because of its favorable effect on quadriceps strength. The aim of this study was to find the minimum volume of local anesthetic, which can be injected into the ACB that would result in quadriceps weakness. METHODS: This nonrandomized study used an up-and-down sequential allocation design. Twenty-six patients scheduled to undergo arthroscopic knee surgery received an ultrasound-guided ACB preoperatively...
November 2017: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/28930857/adductor-canal-block-with-local-infiltrative-analgesia-compared-with-local-infiltrate-analgesia-for-pain-control-after-total-knee-arthroplasty-a-meta-analysis-of-randomized-controlled-trials
#6
Qiujuan Xing, Weiwei Dai, Dongfeng Zhao, Ji Wu, Chunshui Huang, Yun Zhao
BACKGROUND: This meta-analysis aimed to evaluate the efficiency and safety of the combined adductor canal block with peri-articular infiltration versus periarticular infiltration alone for pain control after total knee arthroplasty (TKA). METHODS: PubMed, Medline, Embase, Web of Science, and the Cochrane Library were searched to identify articles comparing the combined adductor canal block with peri-articular infiltration and periarticular infiltration alone for pain control after TKA...
September 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28880902/clonidine-used-as-a-perineural-adjuvant-to-ropivacaine-does-not-prolong-the-duration-of-sensory-block-when-controlling-for-systemic-effects-a-paired-blinded-randomized-trial-in-healthy-volunteers
#7
RANDOMIZED CONTROLLED TRIAL
Jakob Hessel Andersen, Pia Jaeger, Tobias Laier Sonne, Jørgen Berg Dahl, Ole Mathiesen, Ulrik Grevstad
BACKGROUND: Clonidine used as an adjuvant to ropivacaine have been shown to prolong the duration of peripheral nerve blocks. The mechanism of action remains unclear. We hypothesized, that clonidine used as an adjuvant to ropivacaine extends the duration of an adductor canal block (ACB) by a peripheral mechanism, compared to ropivacaine alone when controlling for systemic effects. METHODS: We conducted a paired, blinded, randomized trial in healthy volunteers. Participants received bilateral ACBs containing 20 ml ropivacaine 0...
2017: PloS One
https://www.readbyqxmd.com/read/28868169/relieving-pain-after-arthroscopic-knee-surgery-ultrasound-guided-femoral-nerve-block-or-adductor-canal-block
#8
Poupak Rahimzadeh, Hamid Reza Faiz, Farnad Imani, Geoffrey Grant Hobika, Armaghan Abbasi, Nader D Nader
OBJECTIVE: To compare the analgesic effects of femoral nerve block (FNB) and adductor canal block (ACB) after arthroscopic knee surgery. METHODS: This was a prospective randomised clinical trial that enrolled 92 patients undergoing arthroscopic knee surgery. Ultrasound-guided FNB or ACB was performed immediately after surgery for pain relief. Visual analogue scale (VAS) scores and modified sedation-agitation scale (SAS) were recorded and analysed immediately following block and at 3, 6, 12 and 24 hours...
August 2017: Turkish Journal of Anaesthesiology and Reanimation
https://www.readbyqxmd.com/read/28861197/comparison-of-the-effect-of-continuous-femoral-nerve-block-and-adductor-canal-block-after-primary-total-knee-arthroplasty
#9
Seung Suk Seo, Ok Gul Kim, Jin Hyeok Seo, Do Hoon Kim, Youn Gu Kim, Beyoung Yun Park
BACKGROUND: This study aimed to compare the effects of femoral nerve block and adductor canal block on postoperative pain, quadriceps strength, and walking ability after primary total knee arthroplasty. METHODS: Between November 2014 and February 2015, 60 patients underwent primary total knee arthroplasty. Thirty patients received femoral nerve block and the other 30 received adductor canal block for postoperative pain control. Before spinal anesthesia, the patients received nerve block via a catheter (20 mL 0...
September 2017: Clinics in Orthopedic Surgery
https://www.readbyqxmd.com/read/28799964/the-effect-of-adductor-canal-block-on-knee-extensor-muscle-strength-6-weeks-after-total-knee-arthroplasty-a-randomized-controlled-trial
#10
Nicolas Rousseau-Saine, Stephan R Williams, François Girard, Luc J Hébert, Florian Robin, Luc Duchesne, Frédéric Lavoie, Monique Ruel
BACKGROUND: Total knee arthroplasty (TKA) reduces knee extensor muscle strength (KES) in the operated limb for several months after the surgery. Immediately after TKA, compared to either inguinal femoral nerve block or placebo, adductor canal block (ACB) better preserves KES. Whether this short-term increase in KES is maintained several weeks after surgery remains unknown. We hypothesized that 48 hours of continuous ACB immediately after TKA would improve KES 6 weeks after TKA, compared to placebo...
August 9, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28763413/ultrasound-guided-motor-sparing-knee-blocks-for-postoperative-analgesia-following-total-knee-arthroplasty-a-randomized-blinded-study
#11
RANDOMIZED CONTROLLED TRIAL
Olawale A Sogbein, Rakesh V Sondekoppam, Dianne Bryant, David F Johnston, Edward M Vasarhelyi, Steven MacDonald, Brent Lanting, Sugantha Ganapathy, James L Howard
BACKGROUND: Pain following total knee arthroplasty (TKA) is often severe and can inhibit rehabilitation. Motor-sparing analgesic techniques such as periarticular infiltrations and adductor canal blocks have been popularized for knee analgesia since they preserve motor strength and permit early mobilization. Our primary objective was to compare the duration of analgesia from motor-sparing blocks with that of a standard periarticular infiltration. We used the time to first rescue analgesia as the end point...
August 2, 2017: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/28687982/adductor-canal-block-in-combination-with-posterior-capsular-infiltration-on-the-pain-control-after-tka
#12
M Zhou, H Ding, J Ke
BACKGROUND: Adductor canal block (ACB) and local infiltration anesthesia (LIA) are both widely accepted techniques for postoperative pain control without quadriceps weakness after total knee arthroplasty (TKA). However, the above techniques are insufficient in efficacy or duration. AIMS: The aim of our study was to address whether ACB plus posterior capsular infiltration (PCI) result in improved analgesia compared with ACB or LIA in patients underwent TKA during 48 h after operation...
July 7, 2017: Irish Journal of Medical Science
https://www.readbyqxmd.com/read/28656158/adductor-canal-block-for-knee-surgeries-an-emerging-analgesic-technique
#13
EDITORIAL
Moahammad R Rasouli, Eugene R Viscusi
No abstract text is available yet for this article.
May 2017: Archives of Bone and Joint Surgery
https://www.readbyqxmd.com/read/28627290/continuous-adductor-canal-block-added-to-local-infiltration-analgesia-lia-after-total-knee-arthroplasty-has-no-additional-benefits-on-pain-and-ambulation-on-postoperative-day-1-and-2-compared-with-lia-alone
#14
RANDOMIZED CONTROLLED TRIAL
Svava Gudmundsdottir, Jonas L Franklin
Background and purpose - The additional effects of a continuous adductor canal block (ACB) compared with a single-dose local infiltration anesthesia (LIA) after total knee arthroplasty (TKA) has not been widely researched. Both methods have good effect individually. We hypothesized that a continuous ACB added to a single-dose LIA would lower pain scores while ambulating on postoperative day 1 (POD1) and postoperative day 2 (POD2). Patients and methods - 69 participants were included in this prospective, randomized, double-blind, placebo-controlled trial...
October 2017: Acta Orthopaedica
https://www.readbyqxmd.com/read/28617716/hybrid-blocks-for-total-knee-arthroplasty-a-technical-description
#15
David F Johnston, Rakesh V Sondekoppam, Vishal Uppal, James L Howard, Sugantha Ganapathy
This narrative review article aims to examine current evidence of knee innervation in order to develop a technique of targeting pure sensory innervation of the knee joint without compromising motor function. A literature review of knee innervation was performed to gain an anatomic understanding of terminal sensory branches of the relevant target nerves (femoral, obturator, sciatic, and lateral femoral cutaneous). Pure sensory block of the knee joint is challenging due to important contributions from the muscular innervation close to the joint and the variability of nerves afferents contained within and around the adductor canal...
June 14, 2017: Clinical Journal of Pain
https://www.readbyqxmd.com/read/28606458/is-adductor-canal-block-better-than-femoral-nerve-block-in-primary-total-knee-arthroplasty-a-grade-analysis-of-the-evidence-through-a-systematic-review-and-meta-analysis
#16
REVIEW
Ming-Jie Kuang, Jian-Xiong Ma, Lin Fu, Wei-Wei He, Jie Zhao, Xin-Long Ma
BACKGROUND: Total knee arthroplasty (TKA) is associated with intense postoperative pain with a need for early ambulation to gain function and prevent postoperative complications. Compared with femoral nerve block (FNB), adductor canal block (ACB) can relieve postoperative pain and preserve quadriceps muscle strength. This meta-analysis was conducted to investigate which analgesic method provides better pain relief and functional recovery after TKA. METHOD: We conducted a meta-analysis to identify relevant randomized controlled trials involving ACB and FNB after TKA in electronic databases, including Web of Science, Embase, PubMed, and the Cochrane Library, up to November 2016...
October 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28545172/femoral-nerve-block-versus-adductor-canal-block-for-analgesia-after-total-knee-arthroplasty
#17
REVIEW
In Jun Koh, Young Jun Choi, Man Soo Kim, Hyun Jung Koh, Min Sung Kang, Yong In
Inadequate pain management after total knee arthroplasty (TKA) impedes recovery, increases the risk of postoperative complications, and results in patient dissatisfaction. Although the preemptive use of multimodal measures is currently considered the principle of pain management after TKA, no gold standard pain management protocol has been established. Peripheral nerve blocks have been used as part of a contemporary multimodal approach to pain control after TKA. Femoral nerve block (FNB) has excellent postoperative analgesia and is now a commonly used analgesic modality for TKA pain control...
June 1, 2017: Knee Surgery & related Research
https://www.readbyqxmd.com/read/28464196/does-addition-of-adductor-canal-blockade-to-multimodal-periarticular-analgesia-improve-discharge-status-pain-levels-opioid-use-and-length-of-stay-after-total-knee-arthroplasty
#18
Chukwuweike U Gwam, Jaydev B Mistry, Ifie V Richards, Dhrudeep Patel, Nirav G Patel, Melbin Thomas, Hephzibah Adamu, Ronald E Delanois
Total knee arthroplasty (TKA) can be associated with substantial postoperative pain that may affect satisfaction and return to function. Various forms of pain control have been used; however, multimodal periarticular analgesia (MPA) and adductor canal block (ACB) have recently gained popularity. The purpose of this study was to compare (1) discharge status, (2) pain levels, (3) postoperative opioid consumption, and (4) length of stay (LOS) between TKA patients who received MPA only and those who received both MPA and ACB...
May 2, 2017: Journal of Knee Surgery
https://www.readbyqxmd.com/read/28419047/the-subsartorial-approach-to-the-continuous-adductor-canal-block-safer
#19
Andrew Lansdown, Lucy Kelly, Brett Fritsch, Peter Kam
No abstract text is available yet for this article.
May 2017: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/28410261/successful-continuous-adductor-canal-block-placement-in-a-patient-with-absent-sartorius-muscle-a-case-report
#20
Shin-E Lin, David B Auyong, Aaron B Dahl, Neil A Hanson
We report a novel case of a patient who presented for elective total knee arthroplasty and had distorted adductor canal anatomy due to previous sartorius rotational flap surgery. Despite the lack of a sartorius muscle on the intended operative limb, we describe the successful placement of a continuous adductor canal block. This case is a clinically relevant example that highlights the importance of the vastoadductor membrane as the anatomical anteromedial boundary for the adductor canal, and that it remains intact even after sartorius muscle flap surgery...
August 15, 2017: A & A Case Reports
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