A randomized trial of ultrasound-guided adductor canal block versus fascia iliaca compartment block for postoperative analgesia after arthroscopic knee surgery

Ideal analgesia following knee surgery is needed to encourage early rehabilitation, and to improve functional recovery. We studied the impacts of adductor canal block (ACB) versus fascia iliaca compartment block (FICB) using ultrasound guidance on postoperative analgesia, strength of quadriceps muscle and capability to mobilize following knee arthroscopy.
100 patients scheduled for elective arthroscopic knee surgery were randomly allotted to receive either ACB or FICB using bupivacaine 0.25% with epinephrine (1:2,00,000) at the end of surgery. Visual analogue scale (VAS) was evaluated on admission to PACU, 2, 4, 6, 12, 18 and 24 h postoperative. The quadriceps muscle strength and mobilization ability were assessed at 6, 12, 18 and 24 h postoperative. The postoperative consumption of rescue analgesia and patient's satisfaction were documented.
At 6, 12 and 18 h after block, the quadriceps muscle strength was significantly better in ACB group in comparison with FICB group (P < 0.05). The timed up and go test in ACB group was significantly faster than that of FICB at 6 h, 12 h and 18 h after block (P < 0.001, 95% CI; 25.30–38.22, 30.06–35.95 and 24.09–28.28 respectively). Visual Analogue Scale values, postoperative consumption of rescue analgesia and patient's satisfaction were insignificantly different between both groups.
ACB and FICB provided effective postoperative analgesia for patients experiencing arthroscopic anterior cruciate ligament reconstruction with patellar graft or medial meniscus surgery, with quadriceps muscle strength sparing and early ambulation in ACB patients.