ESRA Academy. Gorecha M. Sep 8, 2016; 138233; 0051 Topic: Lower Limb Blocks - Femoral Nerve Block (including Fascia Iliaca and Saphenous Nerve Block)
Dr. Mahul Gorecha
Dr. Mahul Gorecha

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Background and Aims:

Knee arthroscopy is a common day case procedure where patients are commonly sent home the same day. however, pain control can often be a challenge with patients having to need opiates to control pain. As these patients are sent home the same day, opiate use should be minimised and the use of an adductor canal block may help to reduce opiate consumption whilst still allowing the patient to mobilise as only the saphenous nerve which is purely sensory is blocked. The patient can then be discharged home and advised to take regular oral non opiate analgesia.


As a preliminary case series, 10 patients undergoing minor day case knee arthroscopy were given 100mcg of fentanyl at induction followed by a general anaesthetic and then given an ultrasound guided adductor canal block using a 100mm LPLEX needle with 10ml of 0.25% levobupivacaine injected at the mid-thigh level. Intra-operatively they were given 1g paracetamol and 75mg diclofenac intravenously. Pain relief was assessed in recovery and intravenous morphine was only given if needed.


After the operation patients were reviewed in recovery and assessed for pain relief and motor block. Pain control was very good and there was no need for opioids and no evidence of any motor block. They only reported reduced sensation in the distribution of the saphenous nerve.


In our preliminary case series of 10 patients, adductor canal block when combined with a multi-modal analgesic technique has very promising results in the day case setting where opioid reduction is extremely advantageous.

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