Combined adductor canal and i-PAK blocks is better than combined adductor canal and periarticular injection blocks for painless ACL reconstruction surgery

Abstract

The target of the present study is dual. First, to test the hypothesis of combined nerve block addressing different sites of nerve course can result in more successful distribution and prolongation of block whenever lower concentration local anesthetic mixture is used. Secondly to compare effectiveness of combined Adductor Canal and i-PAK Blocks versus Combined Adductor Canal and Periarticular Injection Blocks for ameliorating postoperative ACL Reconstruction Surgery pain.; Material and methods: The study is a Prospective, randomized cohort study: After IRB (Institutional Review Board) and committee approval was obtained, Patients aged 18-75years undergoing ACL Reconstruction Surgery over the period of one year and included 246 patients which were randomly allocated to either Combined Adductor Canal and i-PAK Blocks (group A), or Combined Adductor Canal and Periarticular Injection Blocks (group B) groups, each had 123 patients at the end of the study. Informed consent for this study was taken from the patient. This is a scientific abstract with no patient protected health information. A standard local anesthetic mixture was used throughout the study. The mixture of Ropivacaine 3.75% with 4mg of dexamethasone in a total volume of 42ml of mixture. There is no off-label medications included. No promotional content of a commercial entity is included (brand/trade/product names, photos, logos, company names, etc.).; Results: This study of the U/S guided comparison of combined Adductor Canal and i-PAK Blocks versus Combined Adductor Canal and Periarticular Injection Blocks For ACL Reconstruction Surgery demonstrates that of combined Adductor Canal and i-PAK Blocks results in prolongation of the time before request for first analgesia rescue (h) (statistically significant) indicated by higher readings in group A compared to group B .Statistically significant difference was also observed comparing the two groups concerning the total pethidine consumption (mg) in the first 48 post-operative hours with much reduction of the total dose in group A together compared to group B.; Postoperative VAPS at rest and on walking were reduced after of combined Adductor Canal and i-PAK Blocks at all-time points assessed compared to group B.; Discussion: The combination of distal blocks is having the advantage of being safer approach away from critical structures and allows preservation of proximal muscle function. The inability to move due to the motor block of proximal and dis…