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Comparing low volume saphenous-obturator block with placebo and femoral-obturator block for anterior cruciate ligament reconstruction: a randomized controlled trial

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@article{f96c06b95bda459e9d98957e13d0762f,
title = "Comparing low volume saphenous-obturator block with placebo and femoral-obturator block for anterior cruciate ligament reconstruction: a randomized controlled trial",
abstract = "BACKGROUND: Anterior cruciate ligament reconstruction (ACL-RC) is often associated with moderate to severe postoperative pain even with a multimodal analgesic regimen. We aimed to compare the analgesic efficacy of low volume saphenous-obturator block with placebo and femoral- obturator block in patients undergoing ACL-RC.METHODS: In a randomized controlled trial eighty-two patients undergoing ACL-RC with hamstring autograft were allocated to either low volume saphenous-obturator block, placebo block or femoral-obturator block. Ropivacaine 0.75{\%} was used for active blocks and saline for placebo. Primary outcome was pain-scores at rest quantified as area-under-the-curve 0-6 hr postoperatively. Secondary outcomes were postoperative opioid consumption and pain localization in the knee.RESULTS: No statistical difference existed between groups in area-under-the-curve 6 hr pain- scores. However, pain-scores were significantly lower in the two ropivacaine groups compared to placebo at emergence t=0 (P<0.018), at t=5 (P<0.042) and at t=6 hours (P<0.002) postoperatively. Furthermore, ropivacaine blocks exhibited significantly reduced total opioid consumption (15.81 and 18.44 mg) postoperatively compared with placebo (26.38 mg) (P<0.018). Patients receiving ropivacaine blocks localized pain in the posterolateral knee, whereas placebo block patients reported anteromedial and central pain. Other secondary outcomes were similar between groups.CONCLUSIONS: Low volume saphenous-obturator block is significantly more effective than placebo in reducing both early and late pain-scores as well as postoperative opioid consumption in patients undergoing ACL-RC. No statistical difference existed when comparing low volume saphenous-obturator block to femoral-obturator block regarding early and late pain-scores and postoperative opioid consumption.",
keywords = "Journal Article",
author = "Katja Lenz and Kenneth Jensen and Katrine Tanggaard and Mojgan Vazin and Bendtsen, {Thomas F} and Vincent Chan and Krogsgaard, {Michael R} and Strube, {Mikael L} and Jens B{\o}rglum",
year = "2018",
month = "2",
doi = "10.23736/S0375-9393.17.11718-9",
language = "English",
volume = "84",
pages = "168--77",
journal = "Minerva Anestesiologica",
issn = "0375-9393",
publisher = "EdizioniMinerva Medica",
number = "2",

}

RIS

TY - JOUR

T1 - Comparing low volume saphenous-obturator block with placebo and femoral-obturator block for anterior cruciate ligament reconstruction

T2 - a randomized controlled trial

AU - Lenz, Katja

AU - Jensen, Kenneth

AU - Tanggaard, Katrine

AU - Vazin, Mojgan

AU - Bendtsen, Thomas F

AU - Chan, Vincent

AU - Krogsgaard, Michael R

AU - Strube, Mikael L

AU - Børglum, Jens

PY - 2018/2

Y1 - 2018/2

N2 - BACKGROUND: Anterior cruciate ligament reconstruction (ACL-RC) is often associated with moderate to severe postoperative pain even with a multimodal analgesic regimen. We aimed to compare the analgesic efficacy of low volume saphenous-obturator block with placebo and femoral- obturator block in patients undergoing ACL-RC.METHODS: In a randomized controlled trial eighty-two patients undergoing ACL-RC with hamstring autograft were allocated to either low volume saphenous-obturator block, placebo block or femoral-obturator block. Ropivacaine 0.75% was used for active blocks and saline for placebo. Primary outcome was pain-scores at rest quantified as area-under-the-curve 0-6 hr postoperatively. Secondary outcomes were postoperative opioid consumption and pain localization in the knee.RESULTS: No statistical difference existed between groups in area-under-the-curve 6 hr pain- scores. However, pain-scores were significantly lower in the two ropivacaine groups compared to placebo at emergence t=0 (P<0.018), at t=5 (P<0.042) and at t=6 hours (P<0.002) postoperatively. Furthermore, ropivacaine blocks exhibited significantly reduced total opioid consumption (15.81 and 18.44 mg) postoperatively compared with placebo (26.38 mg) (P<0.018). Patients receiving ropivacaine blocks localized pain in the posterolateral knee, whereas placebo block patients reported anteromedial and central pain. Other secondary outcomes were similar between groups.CONCLUSIONS: Low volume saphenous-obturator block is significantly more effective than placebo in reducing both early and late pain-scores as well as postoperative opioid consumption in patients undergoing ACL-RC. No statistical difference existed when comparing low volume saphenous-obturator block to femoral-obturator block regarding early and late pain-scores and postoperative opioid consumption.

AB - BACKGROUND: Anterior cruciate ligament reconstruction (ACL-RC) is often associated with moderate to severe postoperative pain even with a multimodal analgesic regimen. We aimed to compare the analgesic efficacy of low volume saphenous-obturator block with placebo and femoral- obturator block in patients undergoing ACL-RC.METHODS: In a randomized controlled trial eighty-two patients undergoing ACL-RC with hamstring autograft were allocated to either low volume saphenous-obturator block, placebo block or femoral-obturator block. Ropivacaine 0.75% was used for active blocks and saline for placebo. Primary outcome was pain-scores at rest quantified as area-under-the-curve 0-6 hr postoperatively. Secondary outcomes were postoperative opioid consumption and pain localization in the knee.RESULTS: No statistical difference existed between groups in area-under-the-curve 6 hr pain- scores. However, pain-scores were significantly lower in the two ropivacaine groups compared to placebo at emergence t=0 (P<0.018), at t=5 (P<0.042) and at t=6 hours (P<0.002) postoperatively. Furthermore, ropivacaine blocks exhibited significantly reduced total opioid consumption (15.81 and 18.44 mg) postoperatively compared with placebo (26.38 mg) (P<0.018). Patients receiving ropivacaine blocks localized pain in the posterolateral knee, whereas placebo block patients reported anteromedial and central pain. Other secondary outcomes were similar between groups.CONCLUSIONS: Low volume saphenous-obturator block is significantly more effective than placebo in reducing both early and late pain-scores as well as postoperative opioid consumption in patients undergoing ACL-RC. No statistical difference existed when comparing low volume saphenous-obturator block to femoral-obturator block regarding early and late pain-scores and postoperative opioid consumption.

KW - Journal Article

U2 - 10.23736/S0375-9393.17.11718-9

DO - 10.23736/S0375-9393.17.11718-9

M3 - Journal article

VL - 84

SP - 168

EP - 177

JO - Minerva Anestesiologica

JF - Minerva Anestesiologica

SN - 0375-9393

IS - 2

ER -

ID: 52645648