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Adductor canal catheter

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https://www.readbyqxmd.com/read/27871518/continuous-ambulatory-adductor-canal-catheters-for-patients-undergoing-knee-arthroplasty-surgery
#1
Neil A Hanson, Phoebe H Lee, Stanley C Yuan, Daniel S Choi, Cindy Jo Allen, David B Auyong
STUDY OBJECTIVE: To determine after knee arthroplasty surgery the feasibility of discharging patients home on postoperative day 1 with continuous adductor canal blocks. DESIGN: Retrospective case series. SETTING: Outpatient setting after hospital discharge. PATIENTS: Patients undergoing knee arthroplasty surgery from October 2013 to August 2014. INTERVENTIONS: All patients received continuous adductor canal catheters for postoperative analgesia and were discharged to home on postoperative day 1...
December 2016: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/27749354/continuous-peripheral-nerve-blocks-an-update-of-the-published-evidence-and-comparison-with-novel-alternative-analgesic-modalities
#2
Brian M Ilfeld
A continuous peripheral nerve block (CPNB) consists of a percutaneously inserted catheter with its tip adjacent to a target nerve/plexus through which local anesthetic may be administered, providing a prolonged block that may be titrated to the desired effect. In the decades after its first report in 1946, a plethora of data relating to CPNB was published, much of which was examined in a 2011 Anesthesia & Analgesia article. The current update is an evidence-based review of the CPNB literature published in the interim...
October 3, 2016: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/27185669/opioid-consumption-in-total-knee-arthroplasty-patients-a-retrospective-comparison-of-adductor-canal-and-femoral-nerve-continuous-infusions-in-the-presence-of-a-sciatic-nerve-catheter
#3
Alberto E Ardon, Steven R Clendenen, Steven B Porter, Christopher B Robards, Roy A Greengrass
OBJECTIVE: To compare opioid consumption among patients who receive a continuous adductor canal block (ACB) versus continuous femoral nerve block (FB) for total knee arthroplasty analgesia in the presence of an intermittent sciatic nerve catheter (iSB). DESIGN: Matched cohort retrospective study. SETTING: Mayo Clinic, Jacksonville, FL. PATIENTS: Ninety patient charts were included in this study: 45 patients with continuous ACB/iSB and 45 with continuous FB/iSB...
June 2016: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/27067467/a-randomized-controlled-trial-comparing-adductor-canal-catheter-and-intraarticular-catheter-after-primary-total-knee-arthroplasty
#4
David H Beausang, John-Paul J Pozek, Antonia F Chen, William J Hozack, Marc W Kaufmann, Marc C Torjman, Jaime L Baratta
BACKGROUND: Multimodal analgesia, including peripheral nerve blocks, is recommended for postoperative pain relief after total knee arthroplasty (TKA). To date, no randomized controlled trial has compared the efficacy of adductor canal catheters (ACCs) and intraarticular catheters (IACs) in patients undergoing TKA. METHODS: A prospective, randomized control trial was performed in 96 primary, unilateral TKA patients comparing ACC with IAC between April, 2014 and August, 2015...
September 2016: Journal of Arthroplasty
https://www.readbyqxmd.com/read/27007076/the-risk-of-falls-after-total-knee-arthroplasty-with-the-use-of-a-femoral-nerve-block-versus-an-adductor-canal-block-a-double-blinded-randomized-controlled-study
#5
RANDOMIZED CONTROLLED TRIAL
Nabil M Elkassabany, Sean Antosh, Moustafa Ahmed, Charles Nelson, Craig Israelite, Ignacio Badiola, Lu F Cai, Rebekah Williams, Christopher Hughes, Edward R Mariano, Jiabin Liu
BACKGROUND: Adductor canal block (ACB) has emerged as an appealing alternative to femoral nerve block (FNB) that produces a predominantly sensory nerve block by anesthetizing the saphenous nerve. Studies have shown greater quadriceps strength preservation with ACB compared with FNB, but no advantage has yet been shown in terms of fall risk. The Tinetti scale is used by physical therapists to assess gait and balance, and total score can estimate a patient's fall risk. We designed this study to test the primary hypothesis that FNB results in a greater proportion of "high fall risk" patients postoperatively using the Tinetti score compared with ACB...
May 2016: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/26885299/can-bedside-patient-reported-numbness-predict-postoperative-ambulation-ability-for-total-knee-arthroplasty-patients-with-nerve-block-catheters
#6
Seshadri C Mudumbai, Toni Ganaway, T Edward Kim, Steven K Howard, Nicholas J Giori, Cynthia Shum, Edward R Mariano
BACKGROUND: Adductor canal catheters offer advantages over femoral nerve catheters for knee replacement patients because they produce less quadriceps muscle weakness; however, applying adductor canal catheters in bedside clinical practice remains challenging. There is currently no patient-reported outcome that accurately predicts patients' physical function after knee replacement. The present study evaluates the validity of a relatively new patient-reported outcome, i.e., a numbness score obtained using a numeric rating scale, and assesses its predictive value on postoperative ambulation...
February 2016: Korean Journal of Anesthesiology
https://www.readbyqxmd.com/read/26863502/continuous-adductor-canal-blocks-does-varying-local-anesthetic-delivery-method-automatic-repeated-bolus-doses-versus-continuous-basal-infusion-influence-cutaneous-analgesia-and-quadriceps-femoris-strength-a-randomized-double-masked-controlled-split-body-volunteer
#7
RANDOMIZED CONTROLLED TRIAL
Amanda M Monahan, Jacklynn F Sztain, Bahareh Khatibi, Timothy J Furnish, Pia Jæger, Daniel I Sessler, Edward J Mascha, Jing You, Cindy H Wen, Ken A Nakanote, Brian M Ilfeld
BACKGROUND: It remains unknown whether continuous or scheduled intermittent bolus local anesthetic administration is preferable for adductor canal perineural catheters. Therefore, we tested the hypothesis that scheduled bolus administration is superior or noninferior to a continuous infusion on cutaneous knee sensation in volunteers. METHODS: Bilateral adductor canal catheters were inserted in 24 volunteers followed by ropivacaine 0.2% administration for 8 hours...
May 2016: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/26129851/a-comparison-of-single-shot-adductor-canal-block-versus-femoral-nerve-catheter-for-total-knee-arthroplasty
#8
COMPARATIVE STUDY
Jordan L Ludwigson, Samuel D Tillmans, Richard E Galgon, Tamara A Chambers, John P Heiner, Kristopher M Schroeder
The aim of this study was to compare perioperative analgesia provided by single-injection adductor canal block (ACB) to continuous femoral nerve catheter (FNC) when used in a multimodal pain protocol for total knee arthroplasty (TKA). A retrospective cohort study compared outcome data for 148 patients receiving a single-injection ACB to 149 patients receiving an FNC. The mean length of stay (LOS) in the ACB group was 2.67 (±0.56) and 3.01 days (±0.57) in the FNC group (P<0.0001). The median ambulatory distances for the adductor group were further than the femoral group for postoperative days 1 (P<0...
September 2015: Journal of Arthroplasty
https://www.readbyqxmd.com/read/26115189/continuous-adductor-canal-versus-continuous-femoral-nerve-blocks-relative-effects-on-discharge-readiness-following-unicompartment-knee-arthroplasty
#9
RANDOMIZED CONTROLLED TRIAL
Jacklynn F Sztain, Anthony T Machi, Nicholas J Kormylo, Wendy B Abramson, Sarah J Madison, Amanda M Monahan, Bahareh Khatibi, Scott T Ball, Francis B Gonzales, Daniel I Sessler, Edward J Mascha, Jing You, Ken A Nakanote, Brian M Ilfeld
BACKGROUND: We tested the hypothesis that, following unicompartment knee arthroplasty, a continuous adductor canal block decreases the time to reach 4 discharge criteria compared with a continuous femoral nerve block. METHODS: Subjects were randomized to either an adductor canal or femoral perineural catheter (2-day ropivacaine 0.2% infusion) in an unmasked fashion. The primary outcome was the time to attain 4 discharge criteria: (1) adequate analgesia; (2) intravenous opioid independence; (3) ability to independently stand, walk 3 m, return, and sit down; and (4) ambulate 30 m...
September 2015: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/26079800/discharge-readiness-after-tricompartment-knee-arthroplasty-adductor-canal-versus-femoral-continuous-nerve-blocks-a-dual-center-randomized-trial
#10
RANDOMIZED CONTROLLED TRIAL
Anthony T Machi, Jacklynn F Sztain, Nicholas J Kormylo, Sarah J Madison, Wendy B Abramson, Amanda M Monahan, Bahareh Khatibi, Scott T Ball, Francis B Gonzales, Daniel I Sessler, Edward J Mascha, Jing You, Ken A Nakanote, Brian M Ilfeld
BACKGROUND: The authors conducted a randomized, controlled, parallel-arm, superiority study to test the hypothesis that a continuous adductor canal block decreases the time to attain four discharge criteria compared with a continuous femoral nerve block after tricompartment knee arthroplasty. METHODS: Subjects undergoing tricompartment knee arthroplasty were randomized using computer-generated lists to either an adductor canal or femoral perineural catheter (3-day ropivacaine 0...
August 2015: Anesthesiology
https://www.readbyqxmd.com/read/25642910/fluoroscopic-evaluation-of-contrast-distribution-within-the-adductor-canal
#11
Stanley C Yuan, Neil A Hanson, David B Auyong, Daniel S Choi, David Coy, Wyndam M Strodtbeck
BACKGROUND AND OBJECTIVES: This case series assesses the in vivo spread of contrast within the adductor canal in subjects who recently underwent a total knee arthroplasty. A previous analysis of profound leg weakness with a continuous adductor canal revealed contrast spread from the adductor canal to the femoral triangle with as little as 2 mL of volume. METHODS: We enrolled 10 American Society of Anesthesiologists class II-III subjects. Maximum voluntary isometric contraction was measured to assess quadriceps strength before and after surgery...
March 2015: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/25510467/comparison-of-catheter-tip-migration-using-flexible-and-stimulating-catheters-inserted-into-the-adductor-canal-in-a-cadaver-model
#12
RANDOMIZED CONTROLLED TRIAL
Christopher A J Webb, T Edward Kim, Natasha Funck, Steven K Howard, T Kyle Harrison, Toni Ganaway, Heidi Keng, Edward R Mariano
Use of adductor canal blocks and catheters for perioperative pain management following total knee arthroplasty is becoming increasingly common. However, the optimal equipment, timing of catheter insertion, and catheter dislodgement rate remain unknown. A previous study has suggested, but not proven, that non-tunneled stimulating catheters may be at increased risk for catheter migration and dislodgement after knee manipulation. We designed this follow-up study to directly compare tip migration of two catheter types after knee range of motion exercises...
June 2015: Journal of Anesthesia
https://www.readbyqxmd.com/read/25430452/ultrasound-guided-continuous-adductor-canal-block-for-analgesia-after-total-knee-replacement
#13
RANDOMIZED CONTROLLED TRIAL
Wei Zhang, Yan Hu, Yan Tao, Xuebing Liu, Geng Wang
BACKGROUND: There are several methods for postoperative analgesia for knee surgery. The commonly utilized method is multimodal analgesia based on continuous femoral nerve block. The aim of this study was to investigate the application of continuous adductor canal block for analgesia after total knee replacement and compare this method with continuous femoral nerve block. METHODS: Sixty patients scheduled for total knee replacement from June 2013 to March 2014 were randomly divided into a femoral group and an adductor group...
2014: Chinese Medical Journal
https://www.readbyqxmd.com/read/25386752/adductor-canal-block-for-postoperative-pain-treatment-after-revision-knee-arthroplasty-a-blinded-randomized-placebo-controlled-study
#14
RANDOMIZED CONTROLLED TRIAL
Pia Jæger, Zbigniew J Koscielniak-Nielsen, Henrik M Schrøder, Ole Mathiesen, Maria H Henningsen, Jørgen Lund, Morten T Jenstrup, Jørgen B Dahl
BACKGROUND: Revision knee arthroplasty is assumed to be even more painful than primary knee arthroplasty and predominantly performed in chronic pain patients, which challenges postoperative pain treatment. We hypothesized that the adductor canal block, effective for pain relief after primary total knee arthroplasty, may reduce pain during knee flexion (primary endpoint: at 4 h) compared with placebo after revision total knee arthroplasty. Secondary endpoints were pain at rest, morphine consumption and morphine-related side effects...
2014: PloS One
https://www.readbyqxmd.com/read/25288506/a-pilot-study-to-assess-adductor-canal-catheter-tip-migration-in-a-cadaver-model
#15
Jody C Leng, T Kyle Harrison, Brett Miller, Steven K Howard, Myles Conroy, Ankeet Udani, Cynthia Shum, Edward R Mariano
An adductor canal catheter may facilitate early ambulation after total knee arthroplasty, but there is concern over preoperative placement since intraoperative migration of catheters may occur from surgical manipulation and result in ineffective analgesia. We hypothesized that catheter type and subcutaneous tunneling may influence tip migration for preoperatively inserted adductor canal catheters. In a male unembalmed human cadaver, 20 catheter insertion trials were divided randomly into one of four groups: flexible epidural catheter either tunneled or not tunneled; or rigid stimulating catheter either tunneled or not tunneled...
April 2015: Journal of Anesthesia
https://www.readbyqxmd.com/read/25217117/a-retrospective-comparative-provider-workload-analysis-for-femoral-nerve-and-adductor-canal-catheters-following-knee-arthroplasty
#16
COMPARATIVE STUDY
Michael Rasmussen, Eugenia Kim, T Edward Kim, Steven K Howard, Seshadri Mudumbai, Nicholas J Giori, Steven Woolson, Toni Ganaway, Edward R Mariano
Adductor canal catheters preserve quadriceps strength better than femoral nerve catheters and may facilitate postoperative ambulation following total knee arthroplasty. However, the effect of this newer technique on provider workload, if any, is unknown. We conducted a retrospective provider workload analysis comparing these two catheter techniques; all other aspects of the clinical pathway remained the same. The primary outcome was number of interventions recorded per patient postoperatively. Secondary outcomes included infusion duration, ambulation distance, opioid consumption, and hospital length of stay...
April 2015: Journal of Anesthesia
https://www.readbyqxmd.com/read/25154949/a-randomized-comparison-of-proximal-and-distal-ultrasound-guided-adductor-canal-catheter-insertion-sites-for-knee-arthroplasty
#17
RANDOMIZED CONTROLLED TRIAL
Edward R Mariano, T Edward Kim, Michael J Wagner, Natasha Funck, T Kyle Harrison, Tessa Walters, Nicholas Giori, Steven Woolson, Toni Ganaway, Steven K Howard
OBJECTIVES: Proximal and distal (mid-thigh) ultrasound-guided continuous adductor canal block techniques have been described but not yet compared, and infusion benefits or side effects may be determined by catheter location. We hypothesized that proximal placement will result in faster onset of saphenous nerve anesthesia, without additional motor block, compared to a distal technique. METHODS: Preoperatively, patients receiving an ultrasound-guided nonstimulating adductor canal catheter for knee arthroplasty were randomly assigned to either proximal or distal insertion...
September 2014: Journal of Ultrasound in Medicine: Official Journal of the American Institute of Ultrasound in Medicine
https://www.readbyqxmd.com/read/24842182/continuous-ultrasound-guided-adductor-canal-block-for-total-knee-arthroplasty-a-randomized-double-blind-trial
#18
RANDOMIZED CONTROLLED TRIAL
Neil A Hanson, Cindy Jo Allen, Lucy S Hostetter, Ryan Nagy, Ryan E Derby, April E Slee, Alex Arslan, David B Auyong
BACKGROUND: Adductor canal blocks have shown promise in reducing postoperative pain in total knee arthroplasty patients. No randomized, controlled studies, however, evaluate the opioid-sparing benefits of a continuous 0.2% ropivacaine infusion at the adductor canal. We hypothesized that a continuous adductor canal block would decrease postoperative opioid consumption. METHODS: Eighty subjects presenting for primary unilateral total knee arthroplasty were randomized to receive either a continuous ultrasound-guided adductor canal block with 0...
June 2014: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/24372058/delayed-quadriceps-weakness-after-continuous-adductor-canal-block-for-total-knee-arthroplasty-a-case-report
#19
Christopher Veal, David B Auyong, Neil A Hanson, Cindy J Allen, Wyndam Strodtbeck
Adductor canal catheters have been shown to improve analgesia while maintaining quadriceps strength after total knee arthroplasty. We describe a patient who underwent total knee arthroplasty that likely had delayed quadriceps weakness as a result of a standard continuous 0.2% ropivacaine infusion at 8 ml/h within the adductor canal. On the day of surgery, the patient was able to stand and ambulate with minimal assistance. On the first post-operative day after surgery, approximately 20 h after starting the ropivacaine infusion, profound weakness of the quadriceps was noted with no ability to stand...
March 2014: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/24121608/adductor-canal-block-versus-femoral-nerve-block-for-analgesia-after-total-knee-arthroplasty-a-randomized-double-blind-study
#20
RANDOMIZED CONTROLLED TRIAL
Pia Jæger, Dusanka Zaric, Jonna S Fomsgaard, Karen Lisa Hilsted, Jens Bjerregaard, Jens Gyrn, Ole Mathiesen, Tommy K Larsen, Jørgen B Dahl
BACKGROUND AND OBJECTIVES: Femoral nerve block (FNB), a commonly used postoperative pain treatment after total knee arthroplasty (TKA), reduces quadriceps muscle strength essential for mobilization. In contrast, adductor canal block (ACB) is predominately a sensory nerve block. We hypothesized that ACB preserves quadriceps muscle strength as compared with FNB (primary end point) in patients after TKA. Secondary end points were effects on morphine consumption, pain, adductor muscle strength, morphine-related complications, and mobilization ability...
November 2013: Regional Anesthesia and Pain Medicine
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