Comparative Evaluation of Multimodal Analgesia Techniques in Total Knee Arthroplasty: A Comparative Study

Effective post-operative pain management is crucial for early mobilization and improved outcomes following total knee arthroplasty (TKA). Multimodal analgesia (MMA) strategies, such as the adductor canal block (ACB) and local infiltration analgesia (LIA) with liposomal bupivacaine, have been developed to enhance pain relief and minimize opioid consumption.

The aim of this study was to compare the efficacy of standard MMA alone with MMA in combination with ACB or LIA in patients undergoing TKA.

A prospective comparative study involving 90 patients undergoing unilateral TKA, who were divided equally into three groups: Group A (standard MMA), Group B (MMA + ACB), and Group C (MMA + LIA). Post-operative pain was measured using the visual analog scale (VAS) at 6, 12, 24, and 48 h. Secondary outcomes included opioid consumption and the study of adverse effects.

Both ACB and LIA significantly decreased VAS scores compared to standard MMA (P < 0.001). Group C (LIA) showed the lowest pain scores, delayed opioid requirements. Opioid consumption and the incidence of side effects were significantly lower in Groups B and C, with Group C exhibiting the most favorable profile.

Both ACB and LIA are effective in improving analgesia and reducing opioid use following TKA. LIA with liposomal bupivacaine provided the most sustained pain relief supporting its use in enhanced recovery protocols.