A continuous adductor canal catheter block did not reduce opioid use after total knee arthroplasty compared with a single-injection nerve block combined with dexamethasone, according to a recent randomized trial led by researchers at New York City-based Hospital for Special Surgery.
The study included 84 adults who underwent primary unilateral total knee arthroplasty between November 2018 and June 2023. Patients were randomly assigned to receive either a continuous infusion adductor canal block or a single-injection block with perineural dexamethasone, according to findings published June 4 in Regional Anesthesia and Pain Medicine.
Researchers found no significant differences in opioid consumption during the 24 to 48 hours after surgery or in the postanesthesia care unit between the two groups. Both strategies also demonstrated similar safety and overall effectiveness.
Patients who received the continuous infusion reported lower pain scores at rest on the second day after surgery. However, catheter-related issues were more common in the continuous infusion group, though the difference was not statistically significant.
The study was led by David Kim, MD. Researchers reported no cases of local anesthetic systemic toxicity. They concluded that continuous adductor canal catheter infusion did not provide meaningful advantages over a single-injection adductor canal block with dexamethasone for opioid reduction, patient satisfaction, functional recovery or adverse effects following total knee arthroplasty.
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