The effect of peripheral nerve blocks on quadriceps muscle strength in knee ligamentoplasty

Abstract

Introduction: Adequate pain control following ligamentoplasty, plays an important role in early mobilization of the patient. The aim of this study was to determine whether with the adductor canal block we can preserve quadriceps muscle strength better than with the femoral nerve block. Secondary end points were pain, additional analgesic request and patient satisfaction. Methods: In this controlled clinical trial, 80 ASA 1 or 2 patients for ligamentoplasty were divided in two groups. Group 1 received an adductor canal block for postoperative analgesia. Group 2 received femoral nerve block. As a rescue analgesic we used tramadol 100 mg. Following parameters were measured: mean dynamometer reading during knee extension at 6, 12 and 24 hours postoperatively as a percentage of the baseline measurement preoperatively, pain during rest at 6, 12 and 24 hours postoperatively, time of the first request of tramadol, the amount of tramadol requested for the first twelve hours and the second twelve hours (12-24 h) postoperatively and the satisfaction score. Results: A significant difference was found in the quadriceps muscle strength measurement at six and 12 hours postoperatively between the groups. There was not a significant difference in the pain scores, in the time of first request of tramadol and the amount requested, between the two groups. There was not a significant difference in the satisfaction score. Conclusion: With the adductor canal block we preserved quadriceps muscle strength better than femoral nerve block and achieved good postoperative analgesia noninferior to femoral nerve block.

Keywords

• postoperative analgesia
• adductor canal block
• femoral nerve block
• ligamentoplasty