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49th Annual Regional Anesthesiology and Acute Pain Medicine Meeting
March 21-23, 2024 | The Hilton Bayfront San Diego | San Diego, California
5245
CONTINUOUS ADDUCTOR CANAL BLOCK FOR AMBULATORY TOTAL KNEE ARTHROPLASTIES: A PILOT PROTOCOL AT TORONTO WESTERN HOSPITAL
Poster Presenter
Part of Topic
Safety/QA/QI Projects
INTRO
• This report describes our experience in establishing CACB service for ambulatory TKA while responding to feedback using Quality Improvement (QI) principles
METHODS
•After thorough discussion and consent pre-operatively, adductor canal block catheters are inserted either pre or post operatively
•Catheters are inserted using trans-fascial oblique approach to prevent dislodgement (figure 1 & 2)
•Successful discharge would depend on ability to perform physiotherapy and pain management. Patients are followed up post-operatively and daily until catheter Is removed.
RESULTS
Our first 50 patients:
•Successful same day discharge : 90%
•Average pain scores for Post Operative Day 1 to 3:
- At rest 3/10, 3/10,2/10respectively.
- On movement 5/10,6/10,6/10respectively (fig 3)
•Percentage of Zero Opioid Consumption Day 1 to3 - 28%,21%29% respectively (figure 4)
•Average Functional Activity Scale for Exercise
- majority scored FAS A or B(figure 5)
•Overall Patient Satisfaction Score: 8.9/10 (figure6)
DISCUSSION:
•Lessons learned along the way from concurrent QI findings and daily follow-ups would further enhance patient's experience and prevent potential issues such as quad weakness, dislodgement, and leaking (Table 1)