79.
Local infiltration analgesia is comparable to femoral nerve block after
anterior cruciate ligament reconstruction with hamstring tendon graft - A
randomized controlled trial.
Pia Kjær Kristensen, Mogens Pfeiffer-Jensen, Jens Ole Storm, Theis
Muncholm Thillemann
Ortopædkirurgisk afd Regions Hospitalet Horsens; Reumatologisk afd., Århus
Universitets hospital; Ortopædkirurgisk afd., Regions Hospitalet Horsens;
Ortopædkirurgisk afd., Regions Hospitalet Horsens
Background:
Arthroscopic anterior cruciate ligament (ACL) reconstruction is
a painful procedure requiring intensive postoperative pain management.
Femoral nerve block (FNB) is widely used in ACL surgery. However, FNB
does not cover the donor site of the hamstring tendons. Local infiltration
analgesia (LIA) is a simple technique that has proven to be effective in the
treatment of postoperative pain after total knee arthroplasty. Further, LIA
covers the donor site and is associated with few complications.
Purpose / Aim of Study:
We hypothesized that LIA at the donorsite and
wounds would decrease pain and opioid consumption.
Materials and Methods:
60
patients undergoing primary ACL surgery with
hamstring tendon graft were randomized to either LIA or FNB. Pain score on
the NRS scale, use of opioid, range of motion and adverse effects were
assessed at the post anesthesia care unit (0 hours), 3 hours, 24 hours and 48
hours, postoperatively.
Findings / Results:
We found no significant differences between the groups in
pain intensity or total opioid consumption at any of the follow-up points. We
observed no differences between groups concerning side effects and range of
motion.
Conclusions:
LIA and FNB are comparable in the management of
postoperative pain after ACL reconstruction with hamstring tendon graft. Until
randomized studies have investigated FNB combined with infiltration at the
donor site we will use LIA in ACL reconstruction with hamstring tendon graft.
