title: Analgesic efficacy of ultrasound-guided adductor canal blockade after arthroscopic anterior cruciate ligament reconstruction: a randomised controlled trial.
abstract: BACKGROUND
  Anterior cruciate ligament (ACL) reconstruction surgery is associated with moderate to severe postoperative pain, which may be ameliorated by peripheral nerve blocks. The adductor canal block (ACB) is an almost exclusively sensory nerve block that has been demonstrated to reduce pain and opioid consumption after major knee surgery.
  
  
  OBJECTIVE
  To investigate the analgesic effect of ACB in patients receiving a basic analgesic regimen of paracetamol and ibuprofen after arthroscopic ACL reconstruction under general anaesthesia.
  
  
  METHODS
  Randomised, double-blind, placebo-controlled, parallel groups.
  
  
  METHODS
  Day Case Surgery, University of Copenhagen, Glostrup Hospital, Denmark, June 2010 to March 2012.
  
  
  METHODS
  Fifty patients, aged 18 to 70 years, scheduled for arthroscopic ACL reconstruction.
  
  
  METHODS
  Patients were randomised to receive ACB with either 30  ml ropivacaine 7.5  mg ml (n = 25) or 30  ml 0.9% saline (n = 24).
  
  
  METHODS
  Primary outcome was pain score (0 to 100  mm) during standing at 2  h after surgery. Secondary outcomes were pain at rest, during standing and after walking 5 m, opioid consumption and opioid-related side effects for 24  h after surgery.
  
  
  RESULTS
  Median (interquartile range) pain scores for the primary outcome were 20 (12 to 36)  mm in the ropivacaine and 20 (10 to 44) mm in the control group (P = 0.84, 95% confidence interval for difference of -9 to 12 mm). No significant differences were observed in any of the secondary outcomes.
  
  
  CONCLUSIONS
  An analgesic regimen with paracetamol and ibuprofen provides acceptable postoperative pain control after arthroscopic ACL reconstruction. ACB did not confer further benefit in our patients.
  
  
  BACKGROUND
  Clinicaltrials.gov Identifier: NCT01212666.
authors.affiliation: Department of Anaesthesiology, University of Copenhagen, Glostrup Hospital, Glostrup, Denmark. Espelund@dadlnet.dk
authors.forename: Malene
authors.initials: M
authors.lastname: Espelund
authors.forename: Jonna S
authors.initials: JS
authors.lastname: Fomsgaard
authors.forename: Jørgen
authors.initials: J
authors.lastname: Haraszuk
authors.forename: Ole
authors.initials: O
authors.lastname: Mathiesen
authors.forename: Jørgen B
authors.initials: JB
authors.lastname: Dahl
mesh_terms: D000082:Acetaminophen / Q000008:administration & dosage; D000293:Adolescent; D000328:Adult; D000368:Aged; D000577:Amides / Q000627:therapeutic use; D000700:Analgesics / Q000627:therapeutic use; D000701:Analgesics, Opioid / Q000008:administration & dosage / Q000627:therapeutic use; D059549:Anterior Cruciate Ligament Reconstruction / Q000379:methods*; D019540:Area Under Curve; D001182:Arthroscopy / Q000379:methods*; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D007052:Ibuprofen / Q000008:administration & dosage; D008297:Male; D008875:Middle Aged; D009407:Nerve Block / Q000379:methods*; D000077212:Ropivacaine; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000577:Amides; D000700:Analgesics; D000701:Analgesics, Opioid; D000082:Acetaminophen; D000077212:Ropivacaine; D007052:Ibuprofen