Syed Aftab Haider, Muhammad Usman Mohsin, Muhammad Adnan, Zeeshan Khan, Muhammad Kaleem Sattar, Ali Ammar

Comparison of Ultrasound‑Guided Femoral Nerve Block (FNB) with Adductor Canal Block (ACB) for Analgesia After Total Knee Arthroplasty

Syed Aftab Haider, Muhammad Usman Mohsin, Muhammad Adnan, Zeeshan Khan, Muhammad Kaleem Sattar, Ali Ammar



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ABSTRACT
Objectives: To compare the femoral nerve block (FNB) with adductor canal block (ACB) in patients undergoing total knee arthroplasty (TKA) in-terms of post-operative pain and quadriceps muscle strength.
Methods: The randomized controlled trial was conducted in department of anesthesiology, Nishtar Hospital Multan. We included 50 patients of age >20 years, who were planned for unilateral TKA. All procedures were done under spinal anesthesia. For induction of block the catheter was inserted into the block site after completion of surgery. Functional mobility was assessed after 24 hours of surgery using the timed up and go (TUG) test.
Results: Mean age was 62.5±7.4 years in ACB group versus 63.2±6.9 in FNB group. There were 17 (68%) female patients in ACB group versus 18 (72%) in FNB group. Mean VAS score after 6 hours was 1.9±0.8 in FNB group versus 2.8±0.7 in ACB group (p-value <0.001). VAS score after 12 hours was 2.0±0.9 in FNB group versus 3.1±1.2 in ACB group (p-value <0.001). After 24 hours, the VAS score was 1.3±0.57 in FNB group versus 2.7±1.0 in ACB group (p-value <0.001). The mean TUG score was 37±7 seconds in ACB group versus 41±8 seconds in FNB group (p-value 0.06).
Conclusion: The ultrasound guided FNB significantly controls post-operative pain after TKA in comparison to ACB without affecting the quadriceps muscle strength.
Keywords: Total knee arthroplasty, post-operative pain.


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