Comparison between adductor canal block and femoral nerve block for different knee surgical procedures. A meta-analysis of randomized trials

Abstract

Background: Femoral nerve block (FNB) is a prevalent technique for analgesia following knee surgeries, but it also results in quadriceps weakness and greater chances of falling. Adductor canal block (ACB) is advertised as a motor nervesparing alternative to FNB. Objectives: The aim of the study was to compare adductor canal block with femoral nerve block as regard different surgical procedures of the knee. Study design: Meta-analysis was used to address this concern. Sittings: Meta-analysis-based study following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Methods: The database MEDLINE, EMBASE, PubMed, and Cochrane were systemically searched to detect all published randomized and prospective clinical trials comparing adductor canal block with femoral nerve block as regard different surgical procedures of the knee in the last five years. Results: Eighteen studies were identified for inclusion in this study, involving a total of 1457 patients. The risk of bias was low. Meta-analysis revealed that groups receiving femoral nerve blocks experience a significant decrease in pain scores and analgesic medication usage. However, adductor canal block groups have a significantly lower rate of quadriceps muscle weakness than FNB groups. Conclusion: Femoral nerve block provides more analgesia and reduces analgesic consumption. On the other hand, adductor canal block, in the early postoperative period, preserves quadriceps function.