title: A Randomized Controlled Trial Comparing Adductor Canal Catheter and Intraarticular Catheter After Primary Total Knee Arthroplasty.
abstract: Multimodal analgesia, including peripheral nerve blocks, is recommended for postoperative pain relief after total knee arthroplasty (TKA). To date, no randomized controlled trial has compared the efficacy of adductor canal catheters (ACCs) and intraarticular catheters (IACs) in patients undergoing TKA.
  
  
  
  A prospective, randomized control trial was performed in 96 primary, unilateral TKA patients comparing ACC with IAC between April, 2014 and August, 2015. Primary outcome measured was numeric pain scores before and after the first physical therapy session on postoperative day 1. Secondary outcomes were oxycodone consumption at 24 and 48 hours, total opioid consumption in morphine equivalents at 24 and 48 hours, active and passive range of motion during physical therapy, patient satisfaction, and length of stay.
  
  
  
  Results demonstrated that the ACC provided significantly better pain control on postoperative day 1 (P = .02) compared with the IAC. ACC trended toward significantly reduced oxycodone consumption at 24 hours postoperatively compared to IAC (25.64 vs 34.67 mg, P = .057). However, total opioid consumption was equivalent between the groups at 24 hours (32.24 vs 38.55 P = .185) or 48 hours (45.2 vs 52.0, P = .330).
  
  
  
  ACC should be considered as part of a multimodal pain regimen after primary, unilateral TKA and provides a better option for pain control after discharge.
authors.affiliation: Department of Anesthesiology, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania.
authors.forename: David H
authors.initials: DH
authors.lastname: Beausang
authors.affiliation: Department of Anesthesiology, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania.
authors.forename: John-Paul J
authors.initials: JP
authors.lastname: Pozek
authors.affiliation: Rothman Institute, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania.
authors.forename: Antonia F
authors.initials: AF
authors.lastname: Chen
authors.affiliation: Rothman Institute, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania.
authors.forename: William J
authors.initials: WJ
authors.lastname: Hozack
authors.affiliation: Department of Anesthesiology, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania.
authors.forename: Marc W
authors.initials: MW
authors.lastname: Kaufmann
authors.affiliation: Department of Anesthesiology, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania.
authors.forename: Marc C
authors.initials: MC
authors.lastname: Torjman
authors.affiliation: Department of Anesthesiology, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania.
authors.forename: Jaime L
authors.initials: JL
authors.lastname: Baratta
mesh_terms: D000368:Aged; D000698:Analgesia / Q000379:methods; D000701:Analgesics, Opioid / Q000627:therapeutic use; D019645:Arthroplasty, Replacement, Knee / Q000379:methods*; D057785:Catheters; D005260:Female; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D009020:Morphine / Q000627:therapeutic use; D009407:Nerve Block / Q000379:methods*; D010098:Oxycodone / Q000627:therapeutic use; D010147:Pain Measurement; D010149:Postoperative Pain / Q000188:drug therapy*; D017060:Patient Satisfaction; D010525:Peripheral Nerves; D011446:Prospective Studies; D016896:Treatment Outcome
chemical_list: D000701:Analgesics, Opioid; D009020:Morphine; D010098:Oxycodone
keywords: adductor canal catheter; intraarticular catheter; multimodal analgesia; opioid consumption; primary knee arthroplasty