EVALUATION OF ADDUCTOR CANAL BLOCK FOR POST OP ANALGESIA AFTER ARTHROSCOPIC ACL RECONSTRUCTION UNDER SPINAL ANAESTHESIA.
Dr Pradeep Brijkishor Sharma, MD (Anaesthesiology),*Dr. Rajesh Kumar Singh, MD (Anaesthesiology) Dr. S Naveen, MD (Anaesthesiology) and Dr. HS Agrawal, MS (Gen Surgery), D Ortho
ABSTRACT
Background: Arthroscopic ACL repair (ACLR) is a common surgery among young productive adults. These adults need to be rehabilitated and discharged back to home at the earliest. Good post-op analgesia without muscle weaknesses plays a very important role in this early mobilization and rehabilitation. Adductor Canal Block (ACB) is fast becoming a mainstay among the various modes of analgesia employed by Anaesthesiologists in such cases. This study was undertaken to evaluate effectiveness of ACB as a post-op analgesia technique in these cases and its usefulness in reducing post-op opioid consumption. Methods: In a zonal government hospital, 100 patients were selected prospectively for ACLR. They were randomly divided in two groups SAB and ACB. SAB group received Sub Arachnoid Block (SAB) with Hyperbaric Bupivacaine with ACB group received SAB followed by ACB under ultrasound guidance with Bupivacaine with Dexamethasone. Post-operatively they were evaluated at hourly intervals for pain score with VAS from 0 to 10 for 6 hours, two hourly for next 6 hours and four hourly for next 12 hours. They all received intravenous (IV) Paracetamol 1000 mg eight hourly. If the pain score crossed 4 they were given intramuscular (IM) Pethidine 50 mg. The time to requirement/demand of rescue analgesia was noted and total doses of opioids given were noted. Results: Mean time to first analgesic rescue was significantly prolonged in Group ACB as compared to Group S. Mean time to rescue analgesia was 978.34 min and 426.57 min in group ACB and SAB respectively. All the patients of the SAB group required at least one opioid dose and 46% needed two doses. Conclusion: ACB is a very effective modality for post-op pain relief after ACLR.
Keywords: Adductor canal block; Knee Arthroscopy; ACL Repair; Sub Arachnoid Block; Spinal Anaesthesia; regional anesthesia.
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