A comparison of adductor canal block before and after thigh tourniquet during knee arthroscopy: a randomized, blinded study

Mursel Ekinci, Bahadir Ciftci, Yavuz Demiraran, Erkan Cem Celik, Murat Yayik, Burak Omur, Ersin Kuyucu, Yunus Oktay Atalay, Mursel Ekinci, Bahadir Ciftci, Yavuz Demiraran, Erkan Cem Celik, Murat Yayik, Burak Omur, Ersin Kuyucu, Yunus Oktay Atalay

Abstract

Background: Adductor canal block (ACB) provides effective analgesia after arthroscopic knee surgery. However, there is insufficient data regarding whether ACB should be performed before or after inflation of a thigh tourniquet. We aimed to investigate the efficacy of ACB performed before and after placement of a thigh tourniquet and evaluate associated quadriceps motor weakness.

Methods: ACB was performed before tourniquet inflation in the PreT group, and it was performed after inflation in the PostT group. In the PO group, ACB was performed at the end of surgery after deflation of the tourniquet.

Results: There were no statistically significant differences between the groups in terms of demographic data. There was no statistically significant difference among the three groups in terms of total postoperative opioid consumption (P = 0.513). Patient satisfaction and the amount of rescue analgesia administered were also not significantly different between the groups. There was no significant difference in terms of static and dynamic visual analog scale scores between the groups (for 24 h: P = 0.306 and P = 0.271, respectively). The incidence of motor block was higher in the PreT group (eight patients) than in the PostT group (no patients) and the PO group (one patient) (P = 0.005).

Conclusions: Using a tourniquet before or after ACB did not result in differences in terms of analgesia quality; however, applying a tourniquet immediately after ACB may lead to quadriceps weakness.

Keywords: Conduction anesthesia; Knee joint; Nerve block; Postoperative pain; Tourniquets; Ultrasonography.

Conflict of interest statement

Conflicts of Interest

No potential conflict of interest relevant to this article was reported.

Figures

Fig. 1.
Fig. 1.
CONSORT flow diagram of the study.
Fig. 2.
Fig. 2.
Probe, needle, tourniquet, and patient position.
Fig. 3.
Fig. 3.
Sonographic anatomy for block procedure. Needle direction and spread of local anesthetic during block performance. Arrows indicate the needle. A: artery, LA: local anesthetic.

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