Evaluation of Post-operative Analgesic Efficacy of Adductor Canal Block Compared to Conventional Intravenous Analgesics in Knee Arthroscopy Surgery

膝关节镜手术中内收肌管阻滞与传统静脉镇痛药术后镇痛效果的评价

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Abstract

BACKGROUND: Effective post-operative pain management is essential for early recovery and patient satisfaction following knee arthroscopy. This study aimed to evaluate the post-operative analgesic efficacy and safety of ultrasound-guided adductor canal block (ACB) compared to conventional intravenous morphine analgesia. MATERIALS AND METHODS: This randomized, controlled, interventional study was conducted in the post-anesthesia care unit (PACU) of the Department of Anesthesiology in an Indian Hospital. Eighty adult patients (American Society of Anesthesiologists [ASA] I-II) undergoing unilateral knee arthroscopy under general anesthesia were randomly divided into two groups: Group M received intravenous morphine (0.1 mg/kg) before incision, and Group B received an ultrasound-guided ACB with 15 mL of 0.25% bupivacaine before extubation. Post-operative analgesic efficacy was assessed by the requirement of rescue analgesia and the time to achieve a Visual Analog Score (VAS) <3. Adverse effects and antiemetic requirements were also recorded. Statistical analysis was performed using the Statistical Package for Social Sciences version 17.0, and a P < 0.05 was considered significant. RESULTS: Both groups were comparable in terms of age, sex, ASA physical status, and pre-operative vitals (P > 0.05). Rescue analgesia in the PACU was required in 47.5% of patients in Group M and 10.0% in Group B (P < 0.001). The mean time to achieve VAS <3 was significantly shorter in Group B (11.00 ± 3.79 min) compared to Group M (16.00 ± 9.00 min) (P = 0.002). The requirement of antiemetic medication was lower in Group B (20.0%) than in Group M (42.5%) (P = 0.030). No adverse events were reported in either group. CONCLUSION: Ultrasound-guided ACB provides superior post-operative analgesia, faster pain relief, and fewer side effects compared to intravenous morphine in patients undergoing knee arthroscopy.

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