Post-operative analgesia using intermittent vs. continuous adductor canal block technique: a randomized controlled...

Area of Science:

• Anesthesiology
• Orthopedic Surgery
• Pain Management

Background:

• Adductor canal block (ACB) is used for post-operative analgesia after anterior cruciate ligament (ACL) reconstruction.
• The optimal administration technique for ACB (intermittent boluses vs. continuous infusion) remains unclear.
• Previous studies suggest intermittent boluses may be superior to continuous infusions for neural blockade analgesia.

Purpose of the Study:

• To compare the efficacy of intermittent boluses versus continuous infusion of ACB for post-operative pain management following ACL reconstruction.
• To determine differences in total morphine consumption and pain scores between the two ACB administration methods.

Main Methods:

• A randomized controlled trial was conducted with 50 patients undergoing ACL reconstruction.
• Patients were assigned to receive either continuous ACB (0.5% ropivacaine at 2.5 ml/h) or intermittent ACB (15 ml of 0.5% ropivacaine every 6 hours).
• The primary outcome was 24-hour total morphine consumption; secondary outcomes included pain scores and opioid-related side effects.

Main Results:

• The intermittent ACB group consumed significantly less morphine over 24 hours (11.36 mg) compared to the continuous ACB group (23.40 mg) (P < 0.001).
• Patients receiving intermittent ACB reported significantly lower visual analogue scale (VAS) pain scores at rest and during knee flexion at 4, 6, 8, and 12 hours post-operatively.
• No specific data on opioid-related side effects were detailed in the abstract.

Conclusions:

• Intermittent ACB administration resulted in significantly reduced post-operative morphine consumption compared to continuous ACB.
• Intermittent ACB provided superior pain relief, as indicated by lower VAS scores, in the early post-operative period following ACL reconstruction.
• The findings support the use of intermittent boluses as a preferred method for ACB administration to optimize post-operative analgesia.