Ultrasound Guided Fascia Iliaca Block versus Adductor Canal Block for Postoperative Analgesia in Knee Arthroscopic Surgeries. "A prospective comparative randomized clinical study"

Abstract

Background: Early rehabilitation after knee arthroscopic surgery is needed to improve functional recovery which is achieved by ideal analgesia.The aim of the work: This study aimed to compare between safety and efficacy of fascia iliaca block [FIB] and adductor canal block [ACB] using ultrasound guidance for post-operative analgesia and motor affection of quadriceps muscle after knee arthroscopic surgeries.Patients and Methods: Sixty patients of American Society of Anesthesiologist [ASA] I and II were included. They were scheduled for elective knee arthroscopic surgeries between April 2017 and October 2018. They were selected from Al-Azhar University Hospital [Damietta, Egypt]. They were randomly allocated to receive either FIB or ACB by bupivacaine 0.25 with ultrasound guidance. Their pain, and sensory block were assessed before and after procedure. The time for first analgesic request and total consumed analgesics were documented.Results: At 30 minutes, 1, 2, 4, 6, 8, 12 and 24 hours, there were no significant differences among the mean value of Numerical Rating Scale [NRS] between FIB and ACB. The first time to introduce morphine and total morphine consumption showed no significant differences between FIB and ACB. There was significant motor affection of FIB in comparison with ACB.Conclusion: FIB and ACB provided effective and safe postoperative analgesia for patients scheduled for knee arthroscopic surgeries, with sparing of quadriceps muscle strength and early ambulation in ACB patients.

Keywords

• fascia iliaca block
• adductor canal block
• post-operative analgesia
• knee arthroscopy