Adductor canal block versus local infiltration analgesia for postoperative pain after anterior cruciate ligament reconstruction: a single centre randomised controlled triple-blinded trial.

Détails

ID Serval
serval:BIB_87E021DFC72B
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Titre
Adductor canal block versus local infiltration analgesia for postoperative pain after anterior cruciate ligament reconstruction: a single centre randomised controlled triple-blinded trial.
Périodique
British journal of anaesthesia
Auteur(s)
Stebler K., Martin R., Kirkham K.R., Lambert J., De Sede A., Albrecht E.
ISSN
1471-6771 (Electronic)
ISSN-L
0007-0912
Statut éditorial
Publié
Date de publication
08/2019
Peer-reviewed
Oui
Volume
123
Numéro
2
Pages
e343-e349
Langue
anglais
Notes
Publication types: Comparative Study ; Journal Article ; Randomized Controlled Trial
Publication Status: ppublish
Résumé
Both the adductor canal block (ACB) and local infiltration analgesia (LIA) are effective analgesic techniques after anterior cruciate ligament (ACL) reconstruction, but they have never been compared head-to-head. This randomised controlled triple-blinded trial tested the hypothesis that ACB provides superior analgesia to LIA after ACL reconstruction, with additional focus on postoperative functional outcomes.
Of 104 enrolled ACL reconstruction patients receiving general anaesthesia, 52 were randomly allocated to either ACB under ultrasound guidance or LIA. For each intervention, ropivacaine 0.5%, 20 ml was injected. Postoperative pain treatment followed a predefined protocol with i.v. patient-controlled morphine, paracetamol, and ibuprofen. The primary outcome was cumulative i.v. morphine consumption at 24 h after operation. Secondary pain-related outcomes included resting and dynamic pain scores (numeric rating scale out of 10) measured 2, 24, and 48 h after operation and cumulative i.v. morphine consumption 2 and 48 h after operation. Early function-related outcomes evaluated were quadriceps strength, walking distance, and range of motion, all measured 24 and 48 h after operation. Late function-related outcomes were concentric quadriceps strength, single-hop test, triple-hop test, cross-over test, and Y balance test, measured at 4 and 8 postoperative months.
Cumulative i.v. morphine consumption at 24 h was similar between groups (ACB group: 17.1 mg [95% confidence interval, CI: 13.1, 21.2]; LIA group: 17.7 mg [95% CI: 13.2, 22.6], P=0.84). Similarly, no differences between groups were seen in the secondary pain- or function-related outcomes.
ACB and LIA result in equivalent postoperative opioid consumption with similar impact on postoperative pain scores and functional outcomes.
NCT02524652.
Mots-clé
Acetaminophen/therapeutic use, Adolescent, Adult, Analgesia/methods, Analgesics, Non-Narcotic/therapeutic use, Analgesics, Opioid/therapeutic use, Anterior Cruciate Ligament Reconstruction, Double-Blind Method, Female, Humans, Ibuprofen/therapeutic use, Male, Middle Aged, Morphine/therapeutic use, Nerve Block/methods, Pain, Postoperative/drug therapy, Prospective Studies, Treatment Outcome, Young Adult, anterior cruciate ligament reconstruction, local infiltration analgesia, postoperative analgesia, regional anaesthesia, ropivacaine
Pubmed
Web of science
Création de la notice
27/05/2019 8:24
Dernière modification de la notice
20/08/2019 14:47
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