Abstract:

Aim: Total knee arthroplasty (TKA) is a major orthopaedic surgery, and patients experience severe postoperative pain. Local infiltration anaesthesia and/or peripheral nerve blocks are often used for analgesia after TKA. The aim of this study was to compare the analgesic efficacy of the local infiltration anaesthesia and adductor canal block (ACB) techniques in the first postoperative 24 hours after TKA. Material and Methods: Sixty patients of both sexes who were aged 40-80 years, in the ASA I-III group and undergoing TKA were included in this study after approval of the local ethics committee. Spinal anaesthesia was achieved with 15 mg 0.5% heavy bupivacaine in all patients. In Group I, nerve blocks were applied under ultrasonography with a 20 mL 0.25% bupivacaine. In Group II, a 60 ml cocktail was injected into the periarticular area and subcutaneous tissue. Postoperative pain was evaluated at 0, 1, 2, 8, 12, and 24 hours with a visual analogue scale (VAS). When the VAS score was >4 or the patient reported a need for pain relief, intravenous analgesics were administered, and the analgesia requirement time was recorded. Statistical analysis was performed with IBM SPSS 23.0 software. A value of p<0.05 was accepted as significant. Results: No statistically significant differences were determined between groups with respect to the demographic data or VAS values (p>0.05). All patients in Group I and 28 patients in Group II required additional analgesia at 10.0±4.9 hours and 8.7±6.02 hours. These differences were not statistically significant (p>0.05). Conclusion: The study showed that both methods provided effective analgesia and can be used for a multimodal analgesia method postoperatively in the first 24 hours after TKA operations.

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