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Current Anesthesiology Reports
Published in: Current Anesthesiology Reports 3/2019

01-09-2019 | Analgesics in Dentistry | Regional Anesthesia (P Kukreja, Section Editor)

The Adductor Canal Block: a Clinical Review

Authors: Sree Kolli, Mohammed Faysal Malik

Published in: Current Anesthesiology Reports | Issue 3/2019

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Abstract

Purpose of Review

To provide an overview of the adductor canal block (ACB), with specific discussion on its scope of practice in regional anesthesia for total knee arthroplasty (TKA).

Recent Findings

ACB is emerging as a viable alternative to femoral nerve block (FNB) as a purely sensory blockade providing comparable postoperative analgesia after TKA. There is growing evidence that it is non-inferior to FNB in terms of pain control, opioid consumption, and earlier ambulation without the risk of quadriceps muscle weakness.

Summary

The saphenous nerve can be effectively blocked at the adductor canal and, in conjunction with a popliteal sciatic nerve block, can be used for analgesia and anesthesia for any procedure below the knee. However, the ACB specifically has emerged as a novel technique consistently demonstrating comparable analgesic efficacy to FNB for TKA. We strongly believe, based on the current evidence available, that the ACB will replace FNB for postoperative analgesia following primary total knee arthroplasty.
Literature
1.
2.
3.
• Manickam B, Perlas A, Duggan E, Brull R, Chan VWS, Ramlogan R. Feasibility and efficacy of ultrasound-guided block of the saphenous nerve in the adductor canal. Reg Anesth Pain Med. 2009;34:578–80 Earliest description of the reliability of ACB technique to block the saphenous nerve. CrossRef
4.
Jæger P, Koscielniak-Nielsen ZJ, Hilsted KL, Fabritius ML, Dahl JB. Adductor canal block with 10 mL versus 30 mL local anesthetics and quadriceps strength: a paired, blinded, randomized study in healthy volunteers. Reg Anesth Pain Med. 2015;40(5):553–8.CrossRef
5.
Horn JL, Pitsch T, Salinas F, Benninger B. Anatomic basis to the ultrasound-guided approach for saphenous nerve blockade. Reg Anesth Pain Med. 2009;34:486–9.CrossRef
6.
Jaeger P, Grevstad U, Henningsen MH, Gottschau B, Mathiesen O, Dahl JB. Effect of adductor-canal-blockade on established, severe post-operative pain after total knee arthroplasty: a randomized study. Acta Anaesthesiol Scand. 2012;56:1013–9.CrossRef
7.
•• Yuan SC, et al. Adductor canal block for total knee arthroplasty: a review of the current evidence. J Anesth Surg. 2016;3(6):1–9 A review of all the current evidence available for ACB. CrossRef
8.
Ludwigson JL, Tillmans SD, Galgon RE, Chambers TA, Heiner JP, Schroeder KM. A comparison of single shot adductor canal block versus femoral nerve catheter for total knee arthroplasty. J Arthroplast. 2015;30(9 Suppl):68–71.CrossRef
9.
Moahammad R, Rasouli MD, Eugene R, Viscusi MD. EDITORIAL Adductor canal block for knee surgeries: an emerging analgesic technique. Arch Bone Jt Surg. 2017;5(3):131–2.
10.
Machi AT, Sztain JF, Kormylo NJ, Madison SJ, Abramson WB, Monahan AM, et al. Discharge readiness after tricompartment knee arthroplasty: adductor canal versus femoral continuous nerve blocks-a dual-center, randomized trial. Anesthesiology. 2015;123(2):444–56.CrossRef
11.
Shah NA, Jain NP, Panchal KA. Adductor canal blockade following total knee arthroplasty-continuous or single shot technique? Role in postoperative analgesia, ambulation ability and early functional recovery: a randomized controlled trial. J Arthroplast. 2015;30(8):1476–81.CrossRef
12.
Andersen HL, Gyrn J, Moller L, et al. Continuous saphenous nerve block as supplement to single-dose local infiltration analgesia for postoperative pain management after total knee arthroplasty. Reg Anesth Pain Med. 2013;38(2):106–11.CrossRef
Metadata
Title
The Adductor Canal Block: a Clinical Review
Authors
Sree Kolli
Mohammed Faysal Malik
Publication date
01-09-2019
Publisher
Springer US
Published in
Current Anesthesiology Reports / Issue 3/2019
Electronic ISSN: 2167-6275
DOI
https://doi.org/10.1007/s40140-019-00335-y

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