Analgesic Impact of a Popliteal Plexus Block to Standard Adductor Canal Block in Arthroscopic Anterior Cruciate Ligament Reconstruction: A Randomized Blind Clinical Trial

Overview

Journal Pain Res Manag

Date 2021 Dec 27

PMID 34956430

Citations 5

Authors

Atef Mahmoud

Maged Boules

Joseph Botros

Mohamed Mostafa

Safaa Ragab

Mohammed Alsaeid

Affiliations

Soon will be listed here.

Abstract

Background: Damage to the anterior cruciate ligament (ACL) is crippling and often requires an arthroscopic outpatient surgery. Nevertheless, many patients experience severe pain during the first day after ACL reconstruction (ACLR). The adductor canal block (ACB) has yielded conflicting results for post-ACLR pain relief. This research investigated the effect of a supplemental popliteal plexus block on postoperative pain outcomes compared to a sole ACB.

Methods: Following a randomized design, 60 cases scheduled for knee arthroscopy with ACLR using an ipsilateral hamstring graft were separated into two categories. Subjects in group A ( = 30) received an ACB only, while subjects in group B ( = 30) received combined ACB and popliteal plexus block (PPB).

Results: We found significant differences between the two groups. The time of the first analgesic request (TFR) was later for the combined ACB and PPB (median 8 h) compared to the ACB only group (median 0.5 h). Morphine consumption was lower for patients who received combined ACB and PPB (median 12 mg) compared to ACB only (median 30 mg). The number of the requested doses was lower for the combined ACB and PPB group (median 3 doses) compared to the ACB only group (median 7 doses).

Conclusions: The addition of PPB to ACB was associated with improved analgesia and a reduced need for opioid-based sedatives following ACLR with an ipsilateral hamstring graft (https://clinicaltrials.gov/ct2/show/NCT04020133).

Citing Articles

Adductor canal block (ACB) plus infiltration of the posterior capsule of the knee (iPACK) block versus 4-in-1 block in an arthroscopic anterior cruciate ligament (ACL) repair: A randomised study.

Roy R, Agarwal G, Ahuja P, Mohta A Indian J Anaesth. 2024; 68(11):959-964.

PMID: 39659538 PMC: 11626880. DOI: 10.4103/ija.ija_671_24.

The analgesic effect of continuous adductor canal block combined with popliteal plexus block for total knee arthroplasty: a randomized controlled trial.

Jiang B, Guo Y, Yang M, Zhang Q, Liu J, Gao M Sci Rep. 2024; 14(1):27757.

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Ultrasound-Guided Genicular Nerve Blocks for Anterior Cruciate Ligament Reconstruction Surgery in an Outpatient Setting: A Case Series.

Ramanujam V, DiMaria S, Varma V Cureus. 2023; 15(9):e44550.

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A quadruple peripheral nerve block outside the OR for anterior cruciate ligament reconstruction reduces the OR occupancy time.

Teulieres M, Berard E, Marot V, Reina N, Ferre F, Minville V Knee Surg Sports Traumatol Arthrosc. 2022; 31(7):2917-2926.

PMID: 36469051 DOI: 10.1007/s00167-022-07246-2.

Minimizing risk of iatrogenic nerve injury during peroneus longus tendon autograft harvest: a cadaveric study at different ankle or knee positions.

Wu S, Rothrauff B, Li J, He J Knee Surg Sports Traumatol Arthrosc. 2022; 31(6):2454-2460.

PMID: 36251045 DOI: 10.1007/s00167-022-07202-0.

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