Evaluation of Ultrasound-Guided Adductor Canal Block With Two Different
Concentration of Bupivacaine in Arthroscopic Knee Surgery, A Pilot
Controlled Feasibility Study
Abstract
Study Objective: The application of regional anesthesia techniques as a
component of multimodal analgesia in knee arthroscopic surgeries
increases the quality of postoperative analgesia. Adductor canal block
(ACB) is an effective “motor sparing” analgesia technique used in knee
surgeries. In this study, we aimed to evaluate the efficacy of two
different concentrations of local anesthetic mixtures in terms of
postoperative analgesia in patients undergoing knee arthroscopic
intervention compared to each other and the control group. Design:
Prospective, randomized, controlled, blinded Setting: Tertiary hospital
Patients: A total of 60 patients (ASA I-II) were evaluated in three
groups, with 20 in each group. Interventions: Standardized postoperative
analgesia was planned for all groups. In addition, ultrasound guided ACB
(same volume / two different concentrations of bupivacaine-0.25% vs
0.16%) was applied to the experimental groups. Measurements: Tramadol
consumption, rescue analgesic requirement and Numeric Rating Scores
(NRS). Main Results: Tramadol requirement in the first 24 hours was
significantly higher in the control group (209.5±23.27
mg),(p<0.001), and there was no difference between the
experimental groups (63±42.06 mg vs 80.5±36.63 mg). Although the mean
NRS score in the first three hours was higher in the control group than
in both block groups, it was similar in all groups in the following
measurements. Conclusion: In arthroscopic knee surgery, ACB
interventions with 0.25% and 0.16% concentrations of bupivacaine were
similar in terms of postoperative analgesic efficacy, and they increased
the quality of multimodal analgesics more than the control group.