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Abstract：
OBJECTIVE: Adductor canal block (ACB) is widely performed for postoperative analgesia for total knee arthroplasty (TKA). The aim of this study is to compare surgeon-assisted and anesthesiologist-assisted (ultrasound-guided) adductor blocks in terms of postoperative analgesic efficacy.
METHODS: This study was designed as a double-blind, prospective and randomized trial. A total of 240 participants were randomly allocated to three groups: one where the surgeon performed the adductor canal block (ACBs), another where it was conducted by an anesthetist with ultrasound guidance (ACBa), and a third group without the adductor block. The follow-up management after the Total Knee Arthroplasty (TKA) procedure occurred on the first, third, and tenth days, as well as the twelfth week. Outcome measures comprised pain assessment using the Visual Analog Scale (VAS) and monitoring opioid analgesic consumption.
RESULTS: No significant differences in demographic profiles were observed between the groups. Groups ACBa and ACBs exhibited significantly lower VAS scores compared to the control group at both 3 and 12 h after surgery, with group ACBa showing the lowest VAS scores among all groups. However, at 1 day, 3 days, 10 days and 12 weeks after surgery, there was no significant difference in VAS scores between the ACBa and ACBs groups. On the first three days, the ACBa group had the lowest opioid consumption and the lowest total opioid consumption. The differences in VAS scores between the groups began to decrease on the first day after surgery.
CONCLUSIONS: The adductor canal block (ACB) has been demonstrated to be an effective method of reducing pain in patients undergoing total knee replacement (TKR) in the postoperative period. Nevertheless, despite the pronounced impact that ACB performed by an anesthesiologist under ultrasound guidance has on VAS scores according to intraoperative ACB by surgeons, its effect on clinical outcomes has not been demonstrated.
BACKGROUND: This study was retrospectively registered with the Clinical Trials Registry Platform on July 31, 2024 (NCT06533085).
METHODS: This study was designed as a double-blind, prospective and randomized trial. A total of 240 participants were randomly allocated to three groups: one where the surgeon performed the adductor canal block (ACBs), another where it was conducted by an anesthetist with ultrasound guidance (ACBa), and a third group without the adductor block. The follow-up management after the Total Knee Arthroplasty (TKA) procedure occurred on the first, third, and tenth days, as well as the twelfth week. Outcome measures comprised pain assessment using the Visual Analog Scale (VAS) and monitoring opioid analgesic consumption.
RESULTS: No significant differences in demographic profiles were observed between the groups. Groups ACBa and ACBs exhibited significantly lower VAS scores compared to the control group at both 3 and 12 h after surgery, with group ACBa showing the lowest VAS scores among all groups. However, at 1 day, 3 days, 10 days and 12 weeks after surgery, there was no significant difference in VAS scores between the ACBa and ACBs groups. On the first three days, the ACBa group had the lowest opioid consumption and the lowest total opioid consumption. The differences in VAS scores between the groups began to decrease on the first day after surgery.
CONCLUSIONS: The adductor canal block (ACB) has been demonstrated to be an effective method of reducing pain in patients undergoing total knee replacement (TKR) in the postoperative period. Nevertheless, despite the pronounced impact that ACB performed by an anesthesiologist under ultrasound guidance has on VAS scores according to intraoperative ACB by surgeons, its effect on clinical outcomes has not been demonstrated.
BACKGROUND: This study was retrospectively registered with the Clinical Trials Registry Platform on July 31, 2024 (NCT06533085).
摘要：
目的：肌管阻滞（ACB）广泛用于全膝关节置换术（TKA）的术后镇痛。这项研究的目的是比较外科医生辅助和麻醉师辅助（超声引导）内收肌阻滞在术后镇痛效果方面。
方法：本研究设计为双盲，前瞻性和随机试验。共有240名参与者被随机分为三组：一组由外科医生进行内收肌管阻滞（ACB），另一个是由麻醉师用超声引导(ACBa)进行的，和没有内收肌阻滞的第三组。全膝关节置换术（TKA）后的随访管理发生在第一次，第三,第十天，以及第十二周。结果测量包括使用视觉模拟量表（VAS）进行疼痛评估和监测阿片类镇痛药的消耗。
结果：两组人口统计学特征无显著差异。与对照组相比，ACBa和ACB组在手术后3小时和12小时均表现出明显较低的VAS评分。ACBa组的VAS评分最低。然而,在1天,3天,手术后10天和12周，ACBa组和ACBs组的VAS评分无显著差异。前三天,ACBa组的阿片类药物消费量最低,总阿片类药物消费量最低.两组之间的VAS评分差异在手术后的第一天开始减少。
结论：内收肌管阻滞（ACB）已被证明是减轻全膝关节置换术（TKR）患者术后疼痛的有效方法。然而，尽管麻醉师在超声引导下进行的ACB对外科医生术中ACB的VAS评分有明显影响，其对临床结局的影响尚未得到证实.
背景：本研究于2024年7月31日在临床试验注册平台进行了回顾性注册（NCT06533085）。
方法：本研究设计为双盲，前瞻性和随机试验。共有240名参与者被随机分为三组：一组由外科医生进行内收肌管阻滞（ACB），另一个是由麻醉师用超声引导(ACBa)进行的，和没有内收肌阻滞的第三组。全膝关节置换术（TKA）后的随访管理发生在第一次，第三,第十天，以及第十二周。结果测量包括使用视觉模拟量表（VAS）进行疼痛评估和监测阿片类镇痛药的消耗。
结果：两组人口统计学特征无显著差异。与对照组相比，ACBa和ACB组在手术后3小时和12小时均表现出明显较低的VAS评分。ACBa组的VAS评分最低。然而,在1天,3天,手术后10天和12周，ACBa组和ACBs组的VAS评分无显著差异。前三天,ACBa组的阿片类药物消费量最低,总阿片类药物消费量最低.两组之间的VAS评分差异在手术后的第一天开始减少。
结论：内收肌管阻滞（ACB）已被证明是减轻全膝关节置换术（TKR）患者术后疼痛的有效方法。然而，尽管麻醉师在超声引导下进行的ACB对外科医生术中ACB的VAS评分有明显影响，其对临床结局的影响尚未得到证实.
背景：本研究于2024年7月31日在临床试验注册平台进行了回顾性注册（NCT06533085）。
