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J Knee Surg
DOI: 10.1055/a-2501-1143
Original Article

Intra-Articular Adductor Canal Block Has Equivalent Analgesic Effect to Traditional Ultrasound-Guided Adductor Canal Block after Total Knee Arthroplasty: A Prospective Randomized Controlled Trial

Deyong Huang   *
1   Department of Orthopaedic Surgery, Beijing Jishuitan Hospital, Capital Medical University, Fourth Clinical College of Peking University, Beijing, China
,
Dazhi Zhang   *
2   Department of Anesthesiology, Beijing Jishuitan Hospital, Capital Medical University, Fourth Clinical College of Peking University, Beijing, China
,
Yi Jiang
1   Department of Orthopaedic Surgery, Beijing Jishuitan Hospital, Capital Medical University, Fourth Clinical College of Peking University, Beijing, China
,
Jun Yi
2   Department of Anesthesiology, Beijing Jishuitan Hospital, Capital Medical University, Fourth Clinical College of Peking University, Beijing, China
,
Ke Sun
2   Department of Anesthesiology, Beijing Jishuitan Hospital, Capital Medical University, Fourth Clinical College of Peking University, Beijing, China
,
Hongyi Shao 
1   Department of Orthopaedic Surgery, Beijing Jishuitan Hospital, Capital Medical University, Fourth Clinical College of Peking University, Beijing, China
› Author Affiliations Funding This work was supported by the internal funding of Beijing Jishuitan Hospital [grant number: XKGG202112].
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Abstract

An adductor canal block (ACB) is widely accepted as a regional nerve block for pain management following total knee arthroplasty (TKA). However, no consensus exists concerning whether the analgesic effect is greater when joint surgeons perform intra-articular ACBs (IA-ACBs) or when anesthesiologists perform ultrasound-guided ACBs (UG-ACBs). We hypothesized that IA-ACBs performed by joint surgeons and UG-ACBs performed by anesthesiologists based on periarticular injections (PAIs) would yield equivalent analgesic effects. This prospective randomized controlled trial included 61 patients who underwent IA-ACBs and 56 patients who received UG-ACB with additional PAI for post-TKA pain management. The primary outcome was postoperative pain assessed using numeric rating scale scores at rest and during exercise. Secondary outcomes included opioid consumption and functional recovery. We also investigated local and systemic adverse events, including nausea, vomiting, and wound complications. Both groups of patients experienced comparable analgesic effects for both IA-ACB and UG-ACB pain management; however, those who received IA-ACBs were prescribed more opioid equivalents than those in the UG-ACB group on postoperative day 1 (p = 0.048). No differences between the groups were observed regarding local or systemic adverse events. IA-ACBs performed by joint surgeons provided equivalent analgesic effects to UG-ACBs performed by anesthesiologists. However, IA-ACBs may lead to a higher postoperative requirement for opioid analgesics.

Keywords

adductor canal block - total knee arthroplasty - pain control

Availability of Data and Material

We have uploaded the original data in the [Supplementary Material], available in the only version only.


Authors' Contributions

D.H. and D.Z.: Conceptualization, data curation, formal analysis, writing–original draft, and writing–review and editing. Y.J.: Data curation, formal analysis, writing–original draft, and writing–review and editing. J.Y.: Conceptualization, data curation, investigation, supervision, and writing–review and editing. H.S. and K.S.: Conceptualization, data curation, formal analysis, investigation, supervision, writing–original draft, and writing–review and editing.


All authors read and approved the final manuscript.


Ethics Approval

This study was performed in line with the principles of the Declaration of Helsinki. The institutional review board of Beijing Jishuitan Hospital approved this study. It was registered in a publicly accessible registry (ChiCTR2000039034) prior to patient recruitment.


* Deyong Huang and Dazhi Zhang contributed equally to this manuscript.


Supplementary Material



Publication History

Received: 14 May 2024

Accepted: 10 December 2024

Accepted Manuscript online:
12 December 2024

Article published online:
20 January 2025

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