Intermittent Bolus via Surgeon-Placed Adductor Canal Catheter for Postoperative Analgesia in Total Knee Arthroplasty: An Observational Longitudinal Study: Intermittent Bolus Adductor Canal Catheter in TKA

Arij Malik; Hafeez Ur Rehman; Aleena Kashif; Junaid Ahmad Shahryar; Umair Abu Bakar; Abu Bakar Siddiq

doi:10.54393/pjhs.v7i7.4265

Authors

Arij Malik Department of Orthopedics, Doctor Hospital and Medical Research Center, Lahore, Pakistan
Hafeez Ur Rehman Department of Orthopedics, Doctor Hospital and Medical Research Center, Lahore, Pakistan
Aleena Kashif Department of Anesthesia, Doctor Hospital and Medical Research Center, Lahore, Pakistan
Junaid Ahmad Shahryar Department of Orthopedics, Doctor Hospital and Medical Research Center, Lahore, Pakistan
Umair Abu Bakar Department of Orthopedics, Doctor Hospital and Medical Research Center, Lahore, Pakistan
Abu Bakar Siddiq Department of Orthopedics, Doctor Hospital and Medical Research Center, Lahore, Pakistan

DOI:

https://doi.org/10.54393/pjhs.v7i7.4265

Keywords:

Adductor Canal Block, Total Knee Arthroplasty, Postoperative Pain, Regional Anesthesia, Analgesia

Abstract

Effective postoperative pain control after total knee arthroplasty (TKA) is essential for early mobilization and better outcomes. The adductor canal block (ACB) provides effective, motor-sparing analgesia. Objectives: To evaluate the efficacy of surgeon-placed ACB in reducing postoperative pain and analgesic requirements in patients undergoing TKA. Methods: This observational longitudinal study was conducted in the hospital's Orthopedic Department from 14^th February 2026 to 13^th May 2026. A total of 38 patients were enrolled through consecutive sampling and underwent standard TKA under spinal anesthesia, with ACB placement by an experienced surgeon. Pain was assessed using the visual analogue scale preoperatively and at 24 and 48 hours postoperatively. Data on time to first analgesia and analgesia consumption during 0-48 hours were collected. Statistical analysis included the Friedman test with Bonferroni-corrected post-hoc comparisons for longitudinal data, and the Wilcoxon Signed-Rank test for postoperative analgesia consumption. Results: Overall mean age was 63.7 ± 7.4 years, and 31 (81.6%) were females. Median pain VAS score decreased from baseline 7.0 (1.0) to 4.0 (2.0) at 24 hours, and 1.0 (2.0) at 48 hours. Similarly, 29 (76.3%) patients required no rescue medication in the first 24 hours, and 32 (84.2%) during the 24–48 hours period. Median analgesia consumption dropped from 0.0 (25.0) mg to 0.0 (0.0) mg across these intervals (p=0.007). Conclusions: The surgeon-placed ACB was associated with low postoperative pain scores and minimal need for rescue analgesia among patients undergoing TKA in this setting.

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