Accelerated recovery protocol in total knee replacement patients: reducing pain and opioid consumption with adductor canal block

Authors : Ayşe Tuğçe Evran, Turan Evran, Rıza Hakan Erbay

Pages : 252-257

View : 24 | Download : 10

Publication Date : 2025-06-18

Article Type : Research Paper

Abstract :Aims: This study aims to evaluate the effects of ultrasound-guided adductor canal block (ACB) on postoperative pain control, opioid consumption, and discharge time in total knee arthroplasty (TKA) operations performed in accordance with enhanced recovery after surgery (ERAS) protocols. Methods: This prospective randomized controlled trial was conducted at Pamukkale University Hospital after obtaining ethical approval. A total of 60 patients who underwent TKA under spinal anesthesia were randomly assigned into two groups. Group I received only local infiltration analgesia (LIA), while group II received both LIA and an ACB. The groups were compared in terms of postoperative Visual Analog Scale (VAS) score at rest and during first ambulation, comparison of tramadol use, dosage, and side effects, time to first ambulation, ambulation distance, quadriceps muscle strength scores, and patient satisfaction and hospital discharge times. Results: Group II showed consistently lower VAS scores compared with group I at all time points, including rest, walking, and sleep (p<0.05). Opioid consumption was significantly higher in group I (p=0.027), and readiness for discharge was delayed in group I compared with group II (p<0.05). Conclusion: In patients undergoing TKA, the combination of LIA and ACB appears to be an effective option in multimodal analgesia practices during the postoperative period and may provide potential benefits in accelerating recovery and reducing opioid-related side effects.
Keywords : adduktor kanal bloğu, fonksiyonel iyileşme, diz artroplastisi, opioid tüketimi, postoperatif ağrı

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