Adductor Canal Block Combined With Local Infiltration Analgesia vs Local Infiltration Analgesia Alone for Postoperative Pain in Total Knee Arthroplasty

Overview

Total knee arthroplasty (TKA) is commonly associated with significant postoperative pain, which may impair early mobilization and functional recovery. Multimodal analgesia techniques are widely used to improve postoperative pain control while minimizing opioid consumption. Local infiltration analgesia (LIA) is a commonly used method; however, its effectiveness may be limited when used alone. The adductor canal block (ACB) provides effective analgesia while preserving quadriceps muscle strength. This prospective randomized controlled study aims to compare the effectiveness of adductor canal block combined with local infiltration analgesia versus local infiltration analgesia alone on postoperative pain scores in patients undergoing total knee arthroplasty. The primary outcome is postoperative pain assessed using the NRS at multiple time points within the first 48 hours. Secondary outcomes include opioid consumption, functional recovery parameters and hemodynamic parameters. The results of this study are expected to contribute to optimizing postoperative analgesia strategies in total knee arthroplasty.

Total knee arthroplasty (TKA) is frequently associated with moderate to severe postoperative pain, which can negatively affect early mobilization, rehabilitation, and patient satisfaction. Effective pain management strategies are essential for enhanced recovery protocols. Multimodal analgesia has become the standard approach, combining different techniques to improve analgesic efficacy while reducing opioid-related side effects. Local infiltration analgesia (LIA) is widely used as part of multimodal analgesia; however, it may not always provide sufficient analgesia when used alone. The adductor canal block (ACB) has gained popularity due to its ability to provide sensory blockade of the saphenous nerve while preserving quadriceps muscle strength, thus facilitating early mobilization. This prospective randomized controlled trial was conducted to evaluate the effect of combining ACB with LIA compared to LIA alone in patients undergoing total knee arthroplasty. Patients were randomly assigned into two groups: one group received ACB combined with LIA, while the control group received LIA alone. Postoperative pain was assessed using the Visual Analog Scale (VAS) at 2, 6, 12, 24 and 48 hours postoperatively. Secondary outcomes included total opioid consumption and functional recovery parameters. Demographic data, operative variables, and perioperative characteristics were also recorded and analyzed. The findings of this study aim to provide evidence regarding the efficacy of combining regional anesthesia techniques with local infiltration analgesia in improving postoperative pain control following total knee arthroplasty.