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ACB administration
after ambulatory knee arthroscopy can reduce pain outcomes and analgesic
consumption but it does not improve analgesic outcomes after anterior cruciate
ligament repair.
Findings from a newly published systematic review and meta-analysis in the Journal of Anesthesia & Analgesia, Adductor canal block (ACB) presents a limited analgesic function in ambulatory arthroscopic knee surgery. Due to the motor-sparing properties of ACB, make it an efficient analgesic regional technique for major knee surgeries; however, its role in ambulatory arthroscopic knee surgery was conflicting.
This analysis tried to validate the exact association between ambulatory arthroscopic knee surgery and ACB by finding suitable randomized controlled trials from ten databases including PubMed-NOT-Medline, MEDLINE, Cochrane Central Controlled Trials Database Register, Cochrane Systematic Reviews Database, CINAHL, Embase, Web of Science, Scopus, Biosys Previews, and Medline In-Process. Pooling of data was done using Random-effects modeling. Both anterior cruciate ligament reconstruction (ACLR) and minor arthroscopic surgeries were considered. Patient satisfaction, opioid consumption, time to first analgesic request, rest and dynamic pain scores, quadriceps strength, opined-related adverse effects, and block-related complications were assessed. For ACLR surgery, no analgesic benefits or improvement in outcomes were noticed and showed similar findings as of femoral nerve block (FNB).
For minor knee
arthroscopic surgery, significant reductions in pain scores, cumulative 24-hour
oral morphine equivalent consumption, and dynamic pain scores were noticed as
compared to the controls. Due to the insufficiency of trials, a careful
interpretation of these outcomes is required. Further analyses are needed to
evaluate the ACB role in the context of graft donor-site analgesia or local
anesthetic instillation.
Anesthesia & Analgesia
Evidence Basis for Regional Anesthesia in Ambulatory Arthroscopic Knee Surgery and Anterior Cruciate Ligament Reconstruction: Part II: Adductor Canal Nerve Block - A Systematic Review and Meta-analysis.
Herman Sehmbi et al.
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