The Implications of Local Anesthetic Volume in Adductor Canal Blockade: An Integrative Review
Michaela Purcell, DNAP, CRNA
- Sigma Affiliation
Visits vs Downloads
Visitors - World Map
Top Visiting Countries
Top Visiting Cities
Visits (last 6 months)
Downloads (last 6 months)
Popular Works for Purcell, Michaela by View
Popular Works for Purcell, Michaela by Download
Introduction: Maintaining patient safety is of utmost concern for anesthesia providers. The adductor canal block, a peripheral nerve block identified as a motor-sparing sensory block, may decrease fall risk and associated adverse outcomes seen in total knee arthroplasty patients following femoral nerve block. A large volume of local anesthetic administered in the adductor canal has been questioned due to concern about impaired quadriceps strength if volume extends beyond the adductor canal, causing an unintended femoral nerve block due to spread of local anesthetic into the femoral triangle.
Methods: A review of literature was performed on the following databases: PubMed, CINAHL Complete, and Cochrane Collection.
Results: A 20 ml volume provides approximately 95% of patients with pain control due to complete distal spread within the adductor canal while ensuring statistically insignificant motor blockade compared to femoral nerve block. Doses of 15 ml no longer provided statistically significant strength preservation 24-hours post-block suggesting volumes less than 20 ml should be avoided. Studies indicate that, although 30 ml volumes may cause proximal spread, the effect on quadriceps strength appears significantly less than that of the femoral nerve block.
Conclusions:: Volumes of 20 to 30 ml are appropriate for adductor canal blockade.
|Type||Other Graduate Paper|
|Review Type||Faculty Approved: Degree-based Submission|
|Evidence Level||Literature Review|
|Research Approach||Translational Research/Evidence-based Practice|
total knee arthroplasty;
|CINAHL Subject(s)||Nerve Block--Methods;
Arthroplasty, Replacement, Knee;
Accidental Falls--Prevention and Control;
Postoperative Pain--Prevention and Control;
All rights reserved by the author(s) and/or publisher(s) listed in this item record unless relinquished in whole or part by a rights notation or a Creative Commons License present in this item record.
All permission requests should be directed accordingly and not to the Sigma Repository.
All submitting authors or publishers have affirmed that when using material in their work where they do not own copyright, they have obtained permission of the copyright holder prior to submission and the rights holder has been acknowledged as necessary.
Showing items related by title, author, creator and subject.
Incorporating Dexamethasone with Local Anesthetics in Single-shot Nerve Blocks: An Integrative Review Hilsabeck, Kyle G. (2018-05-17)Prolonging the duration of analgesia in single-shot nerve blocks (SNBs) continues to be a problem in regional anesthesia. Both IV and perineural dexamethasone have proven to be effective in prolonging the duration of ...
Anesthetic Management in ERAS Protocols for Total Knee and Total Hip Arthroplasty: An Integrative Review Oseka, Laura (2017-07-06)Aims and objectives: The aim of this integrative review is to provide current, evidence-based anesthetic and analgesic recommendations for inclusion in an enhanced recovery after surgery (ERAS) protocol for patients ...
Reiki as a pain management adjunct in the postoperative total knee arthroplasty and surgical obstetric population: An integrative review Knopes, AllisonPain is an undesirable, but anticipated component of surgery. Opioids are routinely administered to manage pain for the millions of surgical procedures performed annually in the United States. Given the rising rate of ...
A randomized controlled trial of an individualized preoperative education intervention for symptom management following total knee arthroplasty Wilson, Rosemary AnnTotal knee arthroplasty (TKA) is a common surgical procedure for the treatment of patients with pain and immobility as a result of osteoarthritis or rheumatoid arthritis. Painrelated interference, pain and nausea are ...