Mu
ltimoda
l ana
lgesia, inc
luding periphera
l nerve b
locks, is recommended for postoperative pain re
lief after tota
l knee arthrop
lasty (TKA). To date, no randomized contro
lled tria
l has compared the efficacy of adductor cana
l catheters (ACCs) and intraarticu
lar catheters (IACs) in patients undergoing TKA.
Methods
A prospective, randomized control trial was performed in 96 primary, unilateral TKA patients comparing ACC with IAC between April, 2014 and August, 2015. Primary outcome measured was numeric pain scores before and after the first physical therapy session on postoperative day 1. Secondary outcomes were oxycodone consumption at 24 and 48 hours, total opioid consumption in morphine equivalents at 24 and 48 hours, active and passive range of motion during physical therapy, patient satisfaction, and length of stay.
Results
Results demonstrated that the ACC provided significantly better pain control on postoperative day 1 (P = .02) compared with the IAC. ACC trended toward significantly reduced oxycodone consumption at 24 hours postoperatively compared to IAC (25.64 vs 34.67 mg, P = .057). However, total opioid consumption was equivalent between the groups at 24 hours (32.24 vs 38.55 P = .185) or 48 hours (45.2 vs 52.0, P = .330).
Conclusion
ACC should be considered as part of a multimodal pain regimen after primary, unilateral TKA and provides a better option for pain control after discharge.