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The adductor canal block has become a common analgesic technique in patients undergoing knee arthroplasty. Dispersion of local anesthetic outside the adductor canal through interfascial layers and blockade of smaller nerves that confer innervation to the knee could contribute to the analgesic efficacy of the adductor canal block. We studied the diffusion of local anesthetic mixed with dye after injection into the adductor canal in fresh human cadavers. In all 8 legs, injectate was found in the popliteal fossa in contact with the sciatic nerve and/or popliteal blood vessels. Interfascial spread patterns were identified.
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http://dx.doi.org/10.1213/ANE.0000000000001441 | DOI Listing |
Drug Des Devel Ther
September 2025
Department of Anesthesiology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, People's Republic of China.
Purpose: This study aimed to compare the analgesic efficacy of liposomal bupivacaine with that of traditional ropivacaine in adductor canal blocks for patients undergoing knee arthroplasty.
Patients And Methods: A total of 119 consenting participants, who were scheduled for elective knee arthroplasty (including total knee replacement and unicompartmental knee replacement) under general anesthesia, were randomly assigned to either receive an ultrasound-guided adductor canal block with ropivacaine or liposomal bupivacaine. The primary endpoint of this study was the pain scores at 2, 24, 48, and 72 hours post-surgery.
Cureus
August 2025
Orthopedics and Spine Surgery, Ganga Medical Centre and Hospitals, Pvt. Ltd, Coimbatore, IND.
Background Total knee arthroplasty (TKA) is often associated with intense postoperative pain, which can delay mobilization and hinder recovery. While motor-sparing blocks such as the femoral triangle block (FTB) and adductor canal block (ACB) are commonly used, both offer incomplete analgesic coverage. To overcome these limitations, the dual subsartorial block (DSB) was introduced as a procedure-specific, motor-sparing technique that combines and modifies FTB and ACB into a dual-injection approach for enhanced efficacy.
View Article and Find Full Text PDFAnaesthesiol Intensive Ther
August 2025
Department of Organization and Management in Health Care, Poznań University of Medical Sciences, Poznań, Poland.
Introduction: Total knee arthroplasty (TKA) is associated with severe pain. We examined whether an ultrasound-guided, single-injection L2 erector spinae plane block could improve analgesia compared to an ultrasound-guided iPACK (infiltration between the popliteal artery and capsule of the knee) block with adductor canal block (ACB) in patients undergoing TKA under spinal anesthesia.
Material And Methods: Ninety patients aged 65-89 years of both sexes (ASA I-III) scheduled for TKA were randomly allocated to receive iPACK block (ropivacaine 0.
Medicine (Baltimore)
August 2025
Department of Anesthesiology and Reanimation, Faculty of Medicine, Bahçeşehir University, Göztepe Medical Park Hospital, Istanbul, Turkiye.
Total knee arthroplasty (TKA) is associated with significant postoperative pain, managed with multimodal analgesia, including regional anesthesia techniques like peripheral nerve blocks. The knee joint's innervation by both sacral and lumbar plexuses often necessitates combined blocks for effective analgesia. This study aimed to compare the effects of suprainguinal fascia iliaca block (SIFIB) and a combination of popliteal artery and posterior knee capsule injection (IPACK) with adductor canal block (ACB) on 24-hour postoperative pain scores, as well as their impact on inflammatory markers and biochemical indicators of myotoxicity.
View Article and Find Full Text PDFBMC Anesthesiol
August 2025
Science and Education Section, Hospital of Chengdu Office of People's Government of Xizang Autonomous Region (Hospital.C.X.), Chengdu, Sichuan, China.
Background: Total Knee Arthroplasty (TKA) requires effective perioperative pain management. The Adductor Canal Block (ACB) is widely used, traditionally administered with conventional anesthetics (e.g.
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