Adductor canal block vs. femoral nerve block in patients undergoing arthroscopic anterior cruciate ligament reconstruction using levobupivacaine: a comparative randomized controlled double-blind study

Abstract

Abstract Background The aim of this study was to compare the efficacy of ultrasound-guided adductor canal block versus femoral nerve block in postoperative analgesia, as well as their effect on quadriceps muscle strength. Results The study included 66 patients who were underwent arthroscopic anterior cruciate ligament reconstruction under general anesthesia. They were randomly divided into 2 groups; A and F, of 33 patients in each. Patients in group A received an adductor canal block, while patients in group F received a femoral nerve block. The primary outcome was the total morphine requirements in the first 24 h after the procedure. Secondary outcomes included time to first analgesic request and the patients’ ability to perform straight leg raise in the post-anesthesia care unit and 2 h later. The straight leg raise was impaired in group F compared with group A both in the post-anesthesia care unit (p value = 0.017) and 2 h postoperatively (p value = 0.020). While there was no differences between both groups regarding time to first analgesic request, and total morphine requirements. Conclusions Compared with femoral nerve block, the adductor canal block may be an effective analgesic alternative with the advantage of sparing the quadriceps muscle strength in anterior cruciate ligament reconstruction surgeries.

Keywords

• Adductor canal block
• Femoral nerve block
• Anterior cruciate ligament reconstruction
• Quadriceps muscle strength