Effect of Adductor Canal Saphenous Nerve Block on Perioperative Pain Management for Children Undergoing Anterior Cruciate Ligament Repair
Mofya S Diallo, Katherine E Negreira, Heather Gordish Dressman, Kaleb L Friend and Sophie R Pestieau
Correspondence Address :
Children’s National Hospital,
111 Michigan Avenue,
N.W.Washington, DC 20010,
United States of America
Received on: November 07, 2019, Accepted on: November 19, 2019, Published on: November 26, 2019
Citation: Mofya S Diallo, Katherine E Negreira, Heather Gordish Dressman, Kaleb L Friend and SophieR Pestieau (2019). Effect of Adductor Canal Saphenous Nerve Block on Perioperative Pain Management for Children Undergoing Anterior Cruciate Ligament Reconstruction
Copyright: Copyright: 2019 Mofya S Diallo, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited
To compare the perioperative opioid requirements and immediate postoperative outcomes following adductor canal saphenous nerve block (SNB) vs. femoral nerve block (FNB) vs. local anesthetic injection by the surgeon alone in children undergoing general anesthesia for anterior cruciate ligament (ACL) reconstruction.
Setting: Operating room and post-operative recovery area
Patients: 105 patients, male and female, ages 11 through 18, who underwent ACL reconstruction at Children’s National Health System between July 2014 and July 2017.
Interventions: As part of their intraoperative anesthetic management, patients received a femoral nerve block (FNB), saphenous nerve block (SNB) or local anesthetic injection by the surgeon.
Measurements: Intraoperative, postoperative, and perioperative opioid requirements were examined along with use of other rescue analgesics, postoperative pain scores, post anesthesia care unit (PACU) length of stay, and admission rate.
Main Results: Total intraoperative and perioperative morphine milligram equivalents (MME) were significantly greater in patients who received local anesthetic at the surgical site only vs a FNB (p=0.009 and p=0.017) and vs a SNB (p<0.001 and p<0.001). No significant difference in total intraoperative and perioperative MME was observed between patients receiving a FNB vs a SNB. There were no significant differences in postoperative pain scores, PACU length of stay, admission rates, and postoperative MME between the groups.
Conclusions: Both FNB and SNB significantly decreased intraoperative and perioperative opioid use compared to local anesthesia only in pediatric patients undergoing ACL reconstruction. Larger and prospective studies are needed to further validate the use of
SNB for these patients, where a SNB might be preferred due to its purely sensory blockade.
Keywords: Nerve block, Pediatrics, Anterior cruciate ligament