Nuts and Bolts of Peripheral Nerve Blocks for Pain After Hip Fracture for Everyday Anesthetist

A range of peripheral nerve blocks is available to treat hip fracture pain, leaving clinicians confused on choice. No single block appears to be outstanding. The article described the relevant anatomy, technical approach, risk associated, and practicability to facilitate a better understanding of the various approaches available. The clinician should be able to make an informed decision based on local requirements and logistics.

Adductor Canal Block in the Outpatient Clinic for Pain Control Following Knee Surgery

Background

Effective postoperative pain control is an important factor for the success of rehabilitation programs. Adductor canal block (ACB) is a recently developed technique.

Objectives

This study aimed to evaluate the application of ACB in patients who underwent knee surgery.

Methods

We performed ACB guided with ultrasonography for patients who underwent knee surgery. ACB was performed 14 days after surgery in the outpatient clinic with a ropivacaine mixture. The pain was evaluated using the visual analogue scale (VAS) every two days.

Results

In this study, 115 patients were included. The mean score of VAS before ACB on the fifth, seventh, and ninth days was 7.4, 7.2, and 6.2, respectively. Mean VAS was significantly decreased after providing the intervention. However, the VAS score was increased gradually until the 23rd day and then flattened. Analgesic (etoricoxib) consumption was 102 mg, 98 mg, and 98 mg in postoperative days (POD), 5th, 7th, and 9th, respectively. Analgesic consumption was significantly decreased (16 mg) after ACB (POD 15th) and gradually increased in PODs 17th, 19th, and 21st. Only one patient complained of thigh hematoma after the ACB procedure.

Conclusions

Single-shot ACB, provided in outpatient clinics, is a safe intervention that could significantly decrease both pain and analgesic consumption. It may enhance the postoperative rehabilitation program.