Background And Objectives: Inadequate pain relief after anterior cruciate ligament reconstruction affects mobility leading to development of adhesions, weakened ligament insertion and muscle atrophy. Adductor canal block for postoperative analgesia preserves quadriceps strength. The present study was conducted to compare pain free period in patients undergoing arthroscopic anterior cruciate ligament reconstruction, receiving ultrasound-guided adductor canal block with ropivacaine alone and ropivacaine with clonidine.
Methods: A prospective randomized double blinded study was conducted including sixty-three adult, ASA class I, II patients undergoing anterior cruciate ligament reconstruction. They were randomized into three groups: Group S – control group received adductor canal block with 30 mL saline, Group R – ropivacaine group received adductor canal block with 30 mL of 0.375% ropivacaine and Group RC – clonidine group received adductor canal block with 30 mL of 0.375% ropivacaine with clonidine 1 μg.kg. The primary aim was to compare the pain free period in patients receiving adductor canal block with ropivacaine alone or ropivacine with clonidine. The secondary outcomes were pain score at rest and movement, total analgesic requirement, sedation score and postoperative nausea and vomiting.
Results: The mean pain free periods were 20 min, 384.76 min and 558.09 min for Group S, Group R and Group RC, respectively and this difference was statistically significant ( < 0.001). There was no significant difference between Group R and Group RC in terms of pain scores at rest and movement and total analgesic requirement.
Conclusion: Addition of clonidine to ropivacaine in USG guided adductor canal block led to significant prolongation of pain free period though pain score at rest and movement, and rescue analgesic requirement, did not differ.
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http://dx.doi.org/10.1016/j.bjan.2018.12.004 | DOI Listing |
J Clin Med
December 2024
Department of Anesthesiology, Duke University Medical Center, DUMC 3094, Durham, NC 27710, USA.
: In 2021, the Food and Drug Administration approved liposomal bupivacaine injectable suspension for single-dose infiltration in patients ≥ 6 years of age. Liposomal bupivacaine and bupivacaine hydrochloride admixtures may also be administered off-label for pediatric regional anesthesia including peripheral nerve blocks (PNBs). This single-injection, long-acting technique is not well described in pediatrics but may have benefits over traditional continuous catheter-based systems.
View Article and Find Full Text PDFActa Ortop Mex
January 2025
Unidad de Investigación. Clínica INDISA. Santiago, Chile.
Introduction: therapeutic equivalence has been established in the effectiveness of peripheral nerve blocks in the management of pain in the postoperative period of anterior cruciate ligament reconstruction. However, it is unknown whether this effect is modulated by the anesthesiologist's experience. The objective was to describe the effectiveness of peripheral nerve blocks during the first 24 hours of the postoperative period, considering patient characteristics and the anesthesiologist's experience.
View Article and Find Full Text PDFBr J Anaesth
January 2025
Department of Theatres, Anaesthesia and Perioperative Medicine, Guy's and St Thomas' NHS Foundation Trust, London, UK; Faculty of Life Sciences and Medicine, King's College London, London, UK.
Total knee arthroplasty is a life-changing surgical procedure that is associated with a high incidence of severe postoperative pain. Key to enhancing recovery after surgery is effective analgesia and early mobilisation. Innovations in motor-sparing regional anaesthesia techniques that have improved recovery include targeted surgical local infiltration analgesia, adductor canal blockade, genicular nerve blocks, and the infiltration between the popliteal artery and posterior capsule of the knee (iPACK) block.
View Article and Find Full Text PDFJ Pain Res
December 2024
Wangjing Hospital, China Academy of Chinese Medical Sciences, Beijing, 100102, People's Republic of China.
J Pediatr Orthop
December 2024
Division of Orthopaedic Surgery, Department of Surgery.
Background: Achieving adequate pain control is vital for proper rehabilitation, satisfaction, and earlier discharge after anterior cruciate ligament reconstruction. Opioids have traditionally been used for this purpose, however, can be associated with various negative outcomes. As such, multimodal analgesia was introduced to reduce postoperative opioid use.
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