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Title: Adductor canal versus femoral triangle anatomical locations for continuous catheter analgesia after total knee arthroplasty: a multicentre randomised controlled study
Authors: Chuan Alwin
Lansdown Andrew
Brick Kelly L
Bourgeois Andre JG
Pencheva LB
Hue Brian
Goddard S
Lennon Mark J
Walters Andrew
Auyong David
Keywords: Adductor Canal
total knee replacement
regional Anaesthesia
total knee arthroplast
postoperative analgesia
femoral triangle
continuous catheter infusion
Source: [Epub ahead of print]
Abstract: Adductor canal (AC) catheters are being used to provide continuous postoperative analgesia after total knee arthroplasty (TKA) surgery. There are anatomical arguments that most AC catheters are being inserted into the femoral triangle (FT) compartment of the thigh rather than the AC compartment. The clinical relevance of this is unknown with respect to motor weakness, quality of analgesia, and opioid consumption. We hypothesised that AC catheters provide superior functional mobilisation on postoperative Day 1 after TKA as measured using the Timed Up and Go (TUG) test. METHODS: In this multinational, multicentre, double-blinded RCT, catheters were inserted under ultrasound guidance into the anatomical AC and FT compartments. The standardised protocol included spinal anaesthesia without intrathecal morphine, fixed catheter infusion rates, and oral analgesia. RESULTS: Of 151 subjects recruited, 75 were in the AC group and 76 in the FT group. There was no statistically significant difference in TUG on postoperative Day 1 between AC (38 [29-55] s) and FT subjects (44 [32-64] s) (median [inter-quartile range]); P=0.11). There was no difference in TUG Day 2, AC (38 [27-53] s) vs FT (42 [31-59] s); P=0.66. There were no statistically significant differences for secondary endpoints of pain level, effectiveness of pain relief, interference of functional activities and interpersonal relationships by pain, and opioid consumption between groups. CONCLUSIONS: There were no differences in immediate postoperative functional mobility, analgesia, and opioid consumption provided by catheters inserted into the AC vs FT locations for TKA surgery.
DOI: 10.1016/j.bja.2019.03.021
ORCID: 0000-0003-4356-6525
PubMed URL: 31056239
Journal Title: British Journal of Anaesthesia
Type: Journal Article
Affiliates: University of New South Wales, Sydney
Royal Prince Alfred Hospital, Sydney
Sir Charles Gairdner Hospital, Perth
Joondaloop Health Campus, Perth
Middlemore Hospital, Auckland
Virginia Mason Medical Center, Seattle
Study/Trial: Case Control Studies
Appears in Collections:Scholarly and Clinical

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