DOI: https://doi.org/10.14710/jai.v0i0.61865

Adductor Canal Block (ACB) as an Adequate Analgesia Post Anterior Cruciate Ligament Repair

Department of Anesthesiology and Intensive Therapy, Orthopedic Prof. Dr. R. Soeharso Hospital, Surakarta, Indonesia

Received: 30 Jan 2024; Revised: 5 Mar 2024; Accepted: 17 Apr 2024; Available online: 24 Jul 2024.
Open Access Copyright 2021 JAI (Jurnal Anestesiologi Indonesia)

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Abstract

Background: Anterior cruriate ligament (ACL) injury is one of the most common cases in knee injury. Inadequate pain management will cause a decrease in quality of life, daily living abilities, increase hospitalization costs, and progressively causing chronic pain. Selection of inappropriate peripheral nerve block (PNB) can reduce range of movement ROM. Abductor canal block (ACB) is expected to facilitate adequate analgetic, improve early mobilization and ambulation, reduce the risk of post operative nausea vomiting (PONV), and needs for other analgetics

Case: A 21-year-old male patient with a diagnosis of ACL rupture knee (S) who will be performed anterior cruriate ligament recontruction (ACLR) procedure with physical status ASA II, premedication ondancentron 4 mg and dexamethasone 5 mg intravenously. Regional anesthesia subarachnoid block, at L3-L4 interspatium with bupivacaine hyperbaric 0.5% 15 mg and fentanyl 25 mcg as the adjuvant for subarachnoid block. Adductor canal block using ultrasound guide using 20 ml levo bupivacaine 0.25%. The outcome assessed using nurmmeric rating score (NRS), PONV, rescue analgetics, and ambulation score which includes: time up to go (TUG) with partial weight bearing, s-CST, 5xSST, 6 WMT straight leg raising (SLR) assessed at more than 48 hours.

Discussion: PNB is proven to be reliable and effective for postoperative pain control, ambulation, rehabilitation and mobilization are also faster, adequate pain control will facilitate early mobilization and prevent side effects related to prolonged immobilization. Adductor canal block is a good modality as an adequate analgetic, the use of ACB can reduce use of rescue analgetic, reduce the incidence of PONV and support early mobilization.

Conclusion: ACB in ACLR can facilitate adequate analgesia, does not require other rescue analgetics, reduce the incidence of PONV, and improve the ambulation as well as avoid other complications.

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Keywords: ACB; anterior cruriate ligament; ambulation; PNB; PONV

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Section: Case Reports
Language : EN
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  1. Bollen SR, Scott BW. Rupture of the anterior cruciate ligament – A quiet epidemic? Injury. 1996;27:407–9. [PubMed] [Google Scholar]
  2. American Society of Anesthesiologists Task Force on Acute Pain Management. Practice guidelines for acute pain management in perioperative settings: An updated report by the American Society of Anesthesiologists Task Force on Acute Pain Management. Anesthesiology. 2012;116:248–73
  3. Laksono RM et all, “Adductor canal block is superior to intravenous analgesia for multimodal postoperative pain management in anterior cririate ligament recontruction” Apicare: 2022
  4. Faraj W Abdallah, M.D, “Adductor Canal Block Provides Noninferior Analgesia and superior Quadricpes Strenght Conpare with Femoral nerve block in anterior cruriate ligament recontruction” Anesthesiology ASAHQ: 2016
  5. Connoly PT, Zittel KW. A coparation of postoperative pain between anterior cruriate ligament recontruction anda repair. Eur J Orthop Surg Traumatol. 2021:31(7):1403-1409
  6. Karnawat R, Gupta M and Suthar OP. Adductor Canal Block for Post- Operative Pain Relief in Knee Surgeries: AReview Article. J Anesth Clin Res 2015, 6:10 http://dx.doi.org/10.4172/2155-6148.1000578
  7. Enstrup M, Jaeger P, Lund J, et al. Effects of adductor-canal-blockade on pain and ambulation after total knee arthroplasty: a randomized study. Acta Anaesthesiol Scand 2012;56(3):357–64
  8. Adams D, Logerstedt D, et al. Current Concepts for Anterior Cruciate Ligament Reconstruction: A Criterion-Based Rehabilitation Progression. JOSPT 2012 42(7): 601-614
  9. Umut Chanbek, Continous Adductor Canal Block for Total knee Replacement, Acta Orthop Turc.2019
  10. Heba, Comparative Study between Adductor Canal Block, Femoral Nerve Block and Epidural Analgesia for Management of Post-Operative Pain in Total Knee Replacement: 2010
  11. Moahammad, Adductor Canal Block for Knee Surgeries: An Emerging Anlgesic Technique Arch Bone Jt Surg. 2017
  12. Calatayud, J.; González, Á. History of the Development and Evolution of Local Anesthesia Since the Coca Leaf. J. Am. Soc. Anesthesiol. 2003, 98, 1503–1508. [Google Scholar] [CrossRef] [PubMed]
  13. Bernetti, A.; Mangone, M.; Paolucci, T.; Santillis, V.; Verna, S.; Agostini, F.; Paoloni, M. Evaluation of the efficacy of intra-articular injective treatment with reticular hyaluronic acid (Mo.Re. Technology) in amateur athletes with over-use gonarthrosis. Med. Dello Sport 2020, 73, 127–139. [Google Scholar]
  14. Weibel S, Rücker G, Eberhart LH, Pace NL, Hartl HM, Jordan OL, et al. Drugs for preventing postoperative nausea and vomiting in adults after general anaesthesia: a network meta-analysis. Cochrane Database Syst Rev. 2020;10:CD012859. [PMC free article] [PubMed] [Google Scholar]
  15. Erdan Kayupov 1, Kamil Okroj 1, Adam C Young 2, Mario Moric 2, Timothy J Luchetti 1, Gilat Zisman 2, Asokumar Buvanendran 2, Tad L Gerlinge. Continuous Adductor Canal Blocks Provide Superior Ambulation and Pain Control Compared to Epidural Analgesia for Primary Knee Arthroplasty: J Arthroplasty doi: 10.1016/j.arth.2017.11.013.Epub2017Nov13
  16. Itai Gans, MD,* Julia S. Retzky, BA,† Lynne C. Jones, PhD,* and Miho J. Tanaka, MD*‡ Epidemiology of Recurrent Anterior Cruciate Ligament Injuries in National Collegiate Athletic Association Sports: The Injury Surveillance Program, 2004-2014 . Orthop J Sports Med. 2018
  17. Daniel E becker, DDS. Lokal Anesthetics: Review Of Pharmacological Considerations. Anest Prog 2012

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