Comparative Study of Adductor Canal Block and Femoral Nerve Block for Postoperative Analgesia After Arthroscopic Anterior Cruciate Ligament Tear Repair Surgeries

Cureus. 2022 Apr 10;14(4):e24007. doi: 10.7759/cureus.24007. eCollection 2022 Apr.

Abstract

Objective: The study aimed to compare an adductor canal block (ACB) with a femoral nerve block (FNB) with regard to their analgesic efficacy and the quadriceps muscle strength in patients following arthroscopic anterior cruciate ligament (ACL) tear repair surgeries.

Materials and methods: Ninety patients in the American Society of Anaesthesiologists (ASA) status I or II undergoing arthroscopic ACL tear repair surgeries under subarachnoid block were divided into three groups to receive ACB (Group ACB), FNB (Group FNB), and control (Group C). Each patient was assessed for Visual Analogue Scale (VAS) score, tramadol consumption, and quadriceps muscle strength postoperatively in the post anaesthesia care unit (PACU).

Results: There was no significant difference between the Group ACB and Group FNB regarding postoperative analgesia and total rescue analgesic consumption at 24 hrs postoperative. The mean VAS score at two, four, and six hours and total rescue analgesic consumption in 24 hrs were higher in the control group, which was statistically significant (p-value <0.05). Quadriceps muscle strength by straight leg raise test was significantly higher in the Group ACB compared with the Group FNB at 0, 6, 12, 18 hours postoperatively (p-value <0.0001), whereas the difference between both study groups become statistically insignificant at 24 hours postoperative.

Conclusion: ACB preserved quadriceps muscle strength better than FNB, without a significant difference in postoperative analgesia after arthroscopic ACL tear repair surgeries.

Keywords: adductor canal block; arthroscopic acl reconstruction; femoral nerve block; quadriceps muscle strength; vas score.