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.

BACKGROUND: Many countries report decreasing on the number of hospital visit even on the emergency cases. AIM: This study aims to reveal the important data on how big the impact of coronavirus-19 pandemic on orthopedic services in two Government’s tertiary-referral hospitals. METHODS: This research is a comparison study to measure the trend of orthopedic services, the monthly orthopedic surgical load and outpatient visit were examined during the period of March to May 2020 (the early pandemic period) then compared to the same period in the 2019. RESULTS: The lowest number of outpatient visits occurred during May 2020 with 715 total number of outpatient visit. The lowest number of orthopedic surgery occurred during May 2020 with 167 total number of orthopedic surgery. Significant decrease of outpatient visits is recorded in 3 months of early pandemic period compared to the same period in 2019 (p < 0.005). Regarding the orthopedic surgical loads, the data show significant decrease in number of orthopedic surgeries in early pandemic period compared to those months in 2019 (p < 0.005). The largest declines were in visits for post-operative control patient (–179), spinal problem (–127,33), and osteoarthritis (–91,33). CONCLUSION: There was a significant difference in outpatient visit and orthopedic surgery number in the early pandemic period compared to the period before the pandemic occur. The largest drops in outpatient visit were in visits for post–operative control patient and spinal problem.

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Background Successful total knee replacement surgery is influenced by surgery and rehabilitation program. We hypothesized the adductor canal block (ACB) in the outpatient clinic is safe, effective for pain relief and decreases analgesic consumption compared with controls. Methods a paired, randomized controlled trial. The intervention group received ACB with 15 mL mixture of ropivacaine 0.2% with isotonic saline and steroids on post-operative day 14 (POD-14) at the outpatient clinic, the control group received daily consumption of analgesic. We evaluated Visual Analog Score (VAS) pain score, and analgesic consumption. Results 35 subjects for each group. In the ACB group, mean of age was 66.42 years old, mean of BMI was 25.87. The control group, mean of age was 64.11 years old, mean of BMI was 25.95. There were significantly different mean VAS scores of both groups and analgesic consumption of both groups on POD 15th, 17th and 19th ( p = 0.00, 0.000 and 0.001, respectively). Two patients complained about hematoma in their thigh (insertion needle) and recovered. Conclusions Single-shot ACB in the outpatient clinic is safe, significantly decreased pain and analgesic consumption and may enhance the rehabilitation program.