Proximal Versus Distal Continuous Adductor Canal Blocks: Does Varying Perineural Catheter Location Influence Analgesia? A Randomized, Subject-Masked, Controlled Clinical Trial

Sztain, Jacklynn F.; Khatibi, Bahareh; Monahan, Amanda M.; Said, Engy T.; Abramson, Wendy B.; Gabriel, Rodney A.; Finneran, John J.; Bellars, Richard H.; Nguyen, Phirum; Ball, Scott T.; Gonzales, Francis B.; Ahmed, Sonya; Donohue, Michael C.; Padwal, Jennifer

doi:10.1213/ane.0000000000003422

Cited by 26 publications

(43 citation statements)

References 29 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…According to the search strategy, a total of 98 studies were retrieved, 23 studies were excluded by Endnote software, and 58 studies were removed upon reading the title and abstract. Finally, 5 RCTs [ 16 – 20 ] were included in our meta-analysis. The basic characteristics and interventions are summarized in Tables 2 and 3 .…”

Section: Resultsmentioning

confidence: 99%

“…The risk of assessment bias is presented in Figures 2 and 3 . Among the 5 RCTs, 3 RCTs [ 16 , 19 , 20 ] reported using computer-generated randomization. Two RCTs [ 17 , 18 ] described allocation concealment via sealed envelopes or other methods.…”

Section: Resultsmentioning

confidence: 99%

“…Four studies, [ 17 – 20 ] including 228 patients, reported total opioid consumption, and no significant differences were found between the 2 groups (MD = -0.77; 95% CI, [-3.22, 1.69]; P = .54; Fig. 5 ).…”

Section: Resultsmentioning

confidence: 99%

“…The worst VAS score was reported in 3 studies [ 17 , 18 , 20 ] including 172 patients. No significant differences were found between the proximal and distal groups (MD = -0.22; 95% CI, [-0.56, 0.11]; P = 0.19; Fig.…”

Section: Resultsmentioning

confidence: 99%

“…However, the optimal location for ACB placement remains controversial. [ 16 – 20 ] Implementing the distal approach may be superior because of the decreased risk of femoral nerve injury, while adding a risk of contaminating the sterile surgical field. [ 21 ] In a study by Romano et al, [ 19 ] a better performance was seen in the proximal group.…”

Section: Introductionmentioning

confidence: 99%

See 4 more Smart Citations

Is the proximal adductor canal block a better choice than the distal adductor canal block for primary total knee arthroplasty?

Zhang

Chen

et al. 2020

Medicine

View full text Add to dashboard Cite

Background: Total knee arthroplasty is accompanied by moderate to severe postoperative pain. Postoperative pain hampers the functional recovery and lowers patient satisfaction with the surgery. Recently, the adductor canal block (ACB) has been widely used in total knee arthroplasty. However, there is no definite answer as to the location of a continuous block within the ACBs. Method: Randomized controlled trials about relevant studies were searched in PubMed (1996 to Oct 2019), Embase (1996 to Oct 2019), and Cochrane Library (CENTRAL, Oct 2019). Results: Five studies involving 348 patients met the inclusion criteria. Pooled data indicated that the proximal ACB was as effective as the distal ACB in terms of total opioid consumption ( P = .54), average visual analog scale (VAS) score ( P = .35), worst VAS score ( P = .19), block success rate ( P = .86), and time of catheter insertion ( P = .54). Conclusions: Compared with the distal ACB, the proximal ACB showed similar analgesic efficacy for total opioid consumption, average VAS score, worst VAS score, block success rate, and time of catheter insertion. However, because of the limited number of involved studies, more high-quality studies are needed to further identify the optimal location of the ACB.

show abstract

Section: Resultsmentioning

confidence: 99%