Outpatient Continuous Adductor Canal Block in Total Knee Arthroplasty:

A Double Blinded Randomized Controlled Trial

Authors: Yehoshua Gleicher, Hermann Dos Santos, Sharon Peacock, Javiera Vargas, Andrés Merchan, Carlson Asanghanwa, Fernanda Oliveira,

Dyvia Mahahan, Christine Ma, Harmsinran Kaur, Naveed Siddiqui.

 

INTRODUCTION

• Pain recovery following total knee arthroplasty (TKA) delays mobilization and

remains a significant barrier for patient recovery.

• Continuous adductor canal blocks (CACB) using a catheter-based technique

can increase the duration of ACB analgesia

• The benefit of CACB in an outpatient setting has yet to be investigated.

METHODS

• Outpatient or short stay primary TKA going home with a CACB (Ropivacaine

0.2% vs Normal saline 0.9%).

• Catheters tunneled using ISAFE technique: Inter-fascial space between the

Sartorius muscle and Femoral artery1

• Primary outcome was total opioid consumption at 48 hours, Secondary

outcomes were: Quality of Recovery (QoR-15) scores, numerical rating scale

(NRS) for pain at rest and movement, hospital length-of-stay (LOS), and CACB

catheter-related complications .

RESULTS

• Fifty-nine patients were included in the intention-to-treat analysis. 29 in the

CACB group and 30 in the control group.

DISCUSSION

• For patients undergoing outpatient or short-stay primary TKA, an outpatient

CACB provides superior analgesia over a SACB. Furthermore, the use of a CACB

resulted in better quality of recovery scores, indicating that the impact of

CACB extends to patient functional recovery.