Application Of Adductor Canal Block And Femoral Nerve Block After Meniscus Surgery

Objective:Comparison of adductor canal block(ACB)and femoral nerve block(FNB)after meniscus repair on postoperative pain score,quadriceps muscle strength grading,dosage and side effects of postoperative analgesic,operation time and complications of nerve block.To investigate the effects of adductor canal block and femoral nerve block on analgesia and muscle strength after meniscus repair,and provide reference for clinical application.Methods:Sixty patients of both sexes,aged 18~60 years,with body mass index of 18~25kg/m2,of American Society of Anesthesiologists physical status I or II,scheduled to have unilateral arthroscopic meniscus repair undergoing subarachnoid anesthesia,were divided into 3 groups using a random number table: ACB group,FNB group and subarachnoid anesthesia group(SA group)with 20 cases each.In the ACB group and FNB group,ACB and FNB were guided by ultrasound before anesthesia,and the drug was 0.3% ropivacaine15 ml.The SA group only received subarachnoid block without other treatment.NRS scale at rest and movement in postoperative 4,8,12,24 h,grading of quadriceps muscle strength at each point in time,additional analgesic dose and side effects,the operation time and complications associated with nerve block were recorded.Results:The NRS scores of ACB group and FNB group were significantly lower than SA group at each time point after operation(P<0.05).There was no significant difference in NRS score between ACB group and FNB group.At 4,8 and 12 h after operation,there was no significant difference in quadriceps muscle strength between SA group and ACB group,but significantly higher than FNB group(P<0.05).There was no significant difference in muscle strength among the three groups at 24 hours after operation.The dosage of analgesics in the SA group was significantly higher than that in the ACB and FNB groups(P<0.05),and the incidence of nausea and vomiting was higher than that in the ACB and FNB groups.Compared with ACB group,the operation time of nerve block in FNB group was shorter,but there was no significant difference between the two groups and neither the FNB group nor the ACB group had significant nerve block complications.Conclusion:Both FNB and ACB can provide effective postoperative analgesia,but the effect of ACB on quadriceps muscle strength is little,so that patients can perform postoperative functional exercise without pain,which is more conducive to the recovery of joint function.