• Clin J Pain · Jun 2022

    Randomized Controlled Trial

    Adductor Canal Blocks with Bupivacaine and Magnesium After Same-day Discharge Total Knee Arthroplasty Improve Post-operative Pain Relief and Decrease Opioid Consumption: A Prospective Randomized Controlled Trial.

    • Jae W Choi, Anna Lahori, John A Merlo, Opinderjit Gill, Farhad Ghoddoussi, Kinjal M Patel, Ronak G Desai, Joffer Hakim, Jason Zatkoff, and Sandeep Krishnan.
    • Department of Anesthesiology, Wayne State University School of Medicine, Detroit.
    • Clin J Pain. 2022 Jun 1; 38 (6): 388-395.

    ObjectivesAdequate pain management is a critical component of facilitating same-day discharge for total knee arthroplasty (TKA). Adductor canal blocks (ACB) have been shown to be an effective technique for managing pain after TKA. The objective of this study was to investigate the impact of adding magnesium to local anesthetic in ACB on postoperative pain, opioid consumption, nausea, and overall patient satisfaction.Materials And MethodsA sample of 119 adults undergoing elective unilateral TKA were included. Patients were randomly assigned to receive ACB with magnesium and bupivacaine (n=56) or with bupivacaine only (n=63). Primary outcomes were total opioid consumption in the first 48 hours after surgery and pain scores. Secondary outcomes were the incidence of nausea in the first 48 hours after surgery and total overall satisfaction.ResultsOpioid consumption decreased significantly in the Mg group compared with the no-Mg group over the first 24 hours (33.2±3.0 vs. 21.3±2.4, P=0.003), the second 24 hours (35.4±2.7 vs. 27.3±2.3, P=0.026), and the first 48 hours total after surgery (68.6±5.1 vs. 48.6±4.3, P=0.004). Pain scores were reduced in the Mg group (24 h: 5.1±2.3 vs. 3.5±2.0, P=0.000; 48 h: 5.1±1.6 vs. 3.9±1.6, P=0.000). Secondary outcomes showed no difference in the incidence of nausea over the first 48 hours and overall satisfaction.ConclusionThe addition of magnesium to local anesthetic in ACB decreases pain scores and opioid consumption, without increasing nausea, when compared with ACB with local anesthetic alone.Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.

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