ANALGESIC EFFICACY OF ADDUCTOR CANAL BLOCK COMBINED WITH GENICULAR NERVE BLOCK AFTER TOTAL KNEE ARTHROPLASTY: A PRELIMINARY CASE SERIES

Đào Ngô Quyền 1 , , Nguyễn Anh Tùng 1 , Nguyễn Thị Hiền 1
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DOI
10.63947/bvtn.v2i9.16
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Published
2026-10-01
Issue Vol. 2 No. 9 (2026): A Major Step Forward in Specialized Care: A Milestone Marked by the First Liver Transplant at Thong Nhat Hospital
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Original Research

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Đào NQ, Nguyễn AT, Nguyễn TH. ANALGESIC EFFICACY OF ADDUCTOR CANAL BLOCK COMBINED WITH GENICULAR NERVE BLOCK AFTER TOTAL KNEE ARTHROPLASTY: A PRELIMINARY CASE SERIES. JHA [Internet]. Vietnam; 2026 Oct. 1 [cited 2026 Oct. 16];2(9):121–127. https://tcsuckhoelaohoa.vn/bvtn/article/view/215 doi: 10.63947/bvtn.v2i9.16
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Abstract

To evaluate the preliminary efficacy, opioid-sparing effect, and safety of ultrasound-guided adductor canal block (ACB) combined with genicular nerve block in total knee arthroplasty (TKA). A prospective case series of 21 primary TKA patients receiving preoperative 4-branch genicular block and postoperative single-injection ACB. Resting VAS (0–48h), cumulative 48-hour fentanyl consumption, complications, and satisfaction were recorded. Patients (95.2% female, mean age 66.1 ± 6.3) showed maximum pain relief at 6h (VAS 0.81 ± 0.60), followed by a rebound at 24h (3.24 ± 0.83; $p < 0.001$) which stabilized through 48h (3.14 ± 0.79). Mean 48-hour fentanyl consumption was 121 ± 34.6 mcg. No procedural complications occurred, and 95.2% of patients were satisfied/very satisfied. Combined ACB and genicular nerve block provides safe, effective early post-TKA analgesia (6–12h) and reduces opioid requirements. Proactive multimodal systemic analgesia is required to manage rebound pain at 12–24 hours.

Keywords

total knee arthroplasty adductor canal block genicular nerve block postoperative analgesia rebound pain ACB

References

  1. O’Donnell R, Dolan J. Anaesthesia and analgesia for knee joint arthroplasty. BJA Educ. 2018;18(1):8-15. doi:10.1016/j.bjae.2017.11.003 DOI: https://doi.org/10.1016/j.bjae.2017.11.003
  2. Lavand’homme PM, Kehlet H, Rawal N, Joshi GP; PROSPECT Working Group of the European Society of Regional Anaesthesia and Pain Therapy (ESRA). Pain management after total knee arthroplasty: PROcedure SPEcific Postoperative Pain ManagemenT recommendations. Eur J Anaesthesiol. 2022;39(9):743-757. doi:10.1097/EJA.0000000000001691 DOI: https://doi.org/10.1097/EJA.0000000000001691
  3. Nguyễn TX, Lê VNK, Nguyễn TH, Hoàng TBN, Hồ LNM, Lê TNB. Đánh giá hiệu quả giảm đau của gây tê ống cơ khép dưới hướng dẫn của siêu âm sau phẫu thuật nội soi khớp gối. Tạp chí Y Học Lâm Sàng Bệnh Viện Trung Ương Huế. 2023;87:88-94. doi:10.38103/jcmhch.87.12 DOI: https://doi.org/10.38103/jcmhch.87.12
  4. Vũ HP, Trịnh DH. Hiệu quả giảm đau sau mổ của phương pháp gây tê ống cơ khép liên tục dưới hướng dẫn của siêu âm ở bệnh nhân phẫu thuật khớp gối. Tạp Chí Nghiên Cứu Y Học. 2020;125(1):45-52. DOI: https://doi.org/10.52852/tcncyh.v142i6.173
  5. Layera S, Aliste J, Bravo D, Saadawi M, Salinas FV, Tran DQ. Motor-sparing nerve blocks for total knee replacement: A scoping review. J Clin Anesth. 2021;68:110076. doi:10.1016/j.jclinane.2020.110076 DOI: https://doi.org/10.1016/j.jclinane.2020.110076
  6. Nguyễn QT, Tống XH, Nguyễn ML, Quách NH, Phan TH, Nguyễn VT. Tác dụng ức chế cảm giác-vận động theo vùng thần kinh chi phối khi gây tê ống cơ khép giảm đau sau phẫu thuật nội soi khớp gối. Tạp Chí Y Dược Lâm Sàng 108. 2021;16(7):112-118. doi:10.52389/ydls.v16i7.897 DOI: https://doi.org/10.52389/ydls.v16i7.897
  7. Mu T, Yuan B, Wei K, Yang Q. Adductor canal block combined with genicular nerve block versus local infiltration analgesia for total knee arthroplasty: a randomized noninferiority trial. J Orthop Surg Res. 2024;19(1):546. doi:10.1186/s13018-024-05048-5 DOI: https://doi.org/10.1186/s13018-024-05048-5
  8. Kukreja P, Venter A, Mason L, et al. Comparison of Genicular Nerve Block in Combination With Adductor Canal Block in Both Primary and Revision Total Knee Arthroplasty: A Retrospective Case Series. Cureus. 2021;13(7):e16712. doi:10.7759/cureus.16712 DOI: https://doi.org/10.7759/cureus.16712
  9. Wang F, Wu J, Wu Y, Han X, Dai H, Chen Q. Different peripheral nerve blocks for patients undergoing total knee arthroplasty: a network meta-analysis of randomized controlled trials. Arch Orthop Trauma Surg. 2024;144(9):4179-4206. doi:10.1007/s00402-024-05507-y DOI: https://doi.org/10.1007/s00402-024-05507-y
  10. González Sotelo V, Maculé F, Minguell J, Bergé R, Franco C, Sala-Blanch X. Ultrasound-guided genicular nerve block for pain control after total knee replacement: Preliminary case series and technical note. Rev Esp Anestesiol Reanim (Engl Ed). 2017;64(10):568-576. doi:10.1016/j.redare.2017.09.005 DOI: https://doi.org/10.1016/j.redare.2017.09.005
  11. Rambhia M, Chen A, Kumar AH, Bullock WM, Bolognesi M, Gadsden J. Ultrasound-guided genicular nerve blocks following total knee arthroplasty: a randomized, double-blind, placebo-controlled trial. Reg Anesth Pain Med. 2021;46(10):862-866. doi:10.1136/rapm-2021-102667 DOI: https://doi.org/10.1136/rapm-2021-102667

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