Comparison Between 3 Solutions of Bupivacaine of Adductor Canal Block for Anterior Cruciate Ligament Reconstruction
Status:
Completed
Trial end date:
2017-06-30
Target enrollment:
Participant gender:
Summary
Adductor canal block (ACB) is a new technique gaining acceptance as an alternative analgesic
method of femoral nerve block (FNB) following knee surgery. The advantage of ACB is its
dominant sensory nerve block effect. It preserves quadriceps muscle strength compared with
the FNB. This will serve as potential gain for early rehabilitation and thereby functional
outcome. Adequate direct injection of local anesthetic into the canal will block four nerves:
the saphenous nerve, the nerve to the vastus medialis, the medial femoral cutaneous nerve,
and the terminal end of the posterior division of the obturator nerve. Anterior cruciate
ligament reconstruction (ACLR) is often associated with postoperative severe pain.
Postoperative early rehabilitation is the primary focus to restore pre-injury status and is
an essential part of the full recovery, especially that this rehabilitation extents over a 6
month period. Early elimination of pain is necessary to achieve this goal. However, there are
no clear conclusive clinical reports defining the adequate analgesic volume-dosage of local
anesthetic for ACB for postoperative ACL pain management. The investigators speculated that
volume-dosage manipulation play key role in the effective of ACB for postoperative pain. The
investigators conducted this prospective, randomized, observer-blinded trial to compare 3
combinations of volume and dosage of 0.25 % bupivacaine for US-guided ACB. The first aim of
the investigation is to compare the analgesic effect of ACB 0.25% bupivacaine of the 3 doses
as assessed by the visual analog scale (VAS) pain scores. The second aim were duration of
analgesia, as defined by first demand for analgesia, and subsequent 24-h consumption.
Physiotherapy tolerance and time to discharge were evaluated. Side effects were also
assessed.