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ADDUCTOR CANAL BLOCK VERSUS FEMORAL NERVE BLOCK FOR ANESTHESIA OF HINDFOOT AND ANKLE SURGERY: PRELIMINARY DATA
ESRA Academy. Joe H. Sep 8, 2016; 138553; 0421 Topic: REGIONAL ANAESTHESIA (RA) TECHNIQUES - CLINICAL IMPLICATIONS
Han Bum Joe
Han Bum Joe

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Abstract
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Background and Aims:

Adductor canal block (ACB) potentially spares motor fibers of the femoral nerve compared to femoral nerve block (FNB), but the comparative effect on foot and ankle surgeries of the two approaches has not been well defined yet. The authors hypothesized that ACB, compared with FNB, would exhibit less quadriceps muscle weakness and demonstrate non-inferior pain score.

Methods:

 Thirty patients scheduled for hindfoot and ankle were randomized to receive ultrasound-guided FNB or ACB in addition to combined SNB. The primary outcome was quadriceps muscle strength. Secondary comparative outcomes included pain scales and time profiles on nerve block. Quadriceps muscle strength were measured by dynamometer before the nerve block, at 30 minutes, 2, 24 and 48 hours after the block. Pain scales using a visual analog scale (VAS, 0-10 cm) score were measured during the operation and at 2, 12 and 24 hours after surgery.


Results:

Fifteen patients received ACB (ACB group, M/F 12/3, mean age = 39.3 years) and the other 15 patients received FNB (FNB group, M/F 13/2, mean age = 37.7 years). At 30 minutes and 2 hours after the block, quadriceps muscle strengths were higher in ACB group than in FNB group, but the muscle strengths were similar in both groups at 24 and 48 hours after the block (Table 1). There were no significant differences in VAS scores, time profiles between two groups (Table 2, 3).

Conclusions:

ACB preserved quadriceps muscle strength better than FNB, without a significant difference in postoperative pain. ACB could be a good alternative to FNB.

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