Femoral Nerve Block and Adductor Canal Block

CA-1 ·

Case context, local only: Knee surgery analgesia, quadriceps-sparing rationale for adductor canal vs femoral, fall-risk evidence.
22Sources
5Kept
2Dropped

1 · Find evidence

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22 candidate papers · 1 excluded

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Source

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7 points

This network meta-analysis found that for total knee arthroplasty, ACB combined with iPACK provides the best pain relief and functional recovery at 48 hours, whereas FNB combined with iPACK is most efficacious for resting pain and opioid reduction at 24 hours. PMID 38692069 — not confirmed against the abstract: The abstract specifies pain and opioid outcomes at 48 hours for ACB+iPACK but does not report functional recovery at that specific time point. dropped
This randomized trial found that while continuous femoral nerve block provides lower morphine use and less pain at 8 and 24 hours after total knee arthroplasty, continuous adductor canal block is superior for early mobility, including muscle strength, standing, and walking. PMID 31574881 — contradicts the point from PMID 39088521: Point 5 states continuous adductor canal block provides pain relief equivalent to continuous femoral nerve block in knee arthroplasty, while point 6 states continuous femoral nerve block provides less pain at 8 and 24 hours than continuous adductor canal block in the same population. dropped
This systematic review found that adding a sciatic nerve block to a femoral nerve block for pediatric or adolescent anterior cruciate ligament reconstruction lowered PACU opioid consumption and VAS pain scores. PMID 39696669 kept
This randomized trial found that for knee arthroscopy, intra-articular local anesthetic provided significantly lower pain scores than an adductor canal block at 1, 2, and 4 hours postoperatively, with no difference in total narcotic consumption. PMID 36807102 kept
This network meta-analysis of adults undergoing primary total knee arthroplasty found that a single-shot adductor canal block provides better 24-hour functional recovery but higher pain scores and opioid consumption compared with a continuous femoral nerve block. PMID 38561898 kept
This randomised controlled trial found that femoral nerve block and adductor canal block provide comparable early postoperative pain control, knee function, and activities of daily living after double-bundle anterior cruciate ligament reconstruction with hamstring autografts. PMID 33609182 kept
This meta-analysis of knee arthroplasty patients found that continuous adductor canal block provides pain relief equivalent to continuous femoral nerve block while better preserving quadriceps muscle strength and shortening discharge readiness time. PMID 39088521 kept

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