Evaluation of Ultrasound-Guided Adductor Canal Block With Two
Different Concentration of Bupivacaine in Arthroscopic Knee Surgery, A
Pilot Controlled
Feasibility Study
Study Objective: The application of regional anesthesia
techniques as a component of multimodal analgesia in knee arthroscopic
surgeries increases the quality of postoperative analgesia. Adductor
canal block (ACB) is an effective ”motor sparing” analgesia technique
used in knee surgeries. In this study, we aimed to evaluate the efficacy
of two different concentrations of local anesthetic mixtures in terms of
postoperative analgesia in patients undergoing knee arthroscopic
intervention compared to each other and the control group.
Design: Prospective, randomized, controlled, blinded
Setting: Tertiary hospital
Patients: A total of 60 patients (ASA I-II) were evaluated in
three groups, with 20 in each group.
Interventions: Standardized postoperative analgesia was planned
for all groups. In addition, ultrasound guided ACB (same volume / two
different concentrations of bupivacaine-0.25% vs 0.16%) was applied to
the experimental groups.
Measurements: Tramadol consumption, rescue analgesic
requirement and Numeric Rating Scores (NRS).
Main Results: Tramadol requirement in the first 24 hours was
significantly higher in the control group (209.5±23.27
mg),(p<0.001), and there was no difference between the
experimental groups (63±42.06 mg vs 80.5±36.63 mg). Although the mean
NRS score in the first three hours was higher in the control group than
in both block groups, it was similar in all groups in the following
measurements.
Conclusion: In arthroscopic knee surgery, ACB interventions
with 0.25% and 0.16% concentrations of bupivacaine were similar in
terms of postoperative analgesic efficacy, and they increased the
quality of multimodal analgesics more than the control group.
Keywords: Adductor canal block, Ultrasound guided regional
anesthesia, Pain management, Knee arthroplasty, Lower extremity block,
Bupivacaine concentration