Comparison of adductor canal block and femoral nerve block for pain management in anterior cruciate ligament reconstruction

OBJECTIVE: To compare the efficacy of adductor canal block and femoral nerve block for pain management in patients with anterior cruciate ligament reconstruction. METHODS: A computerized search was performed in the database of PubMed, Embase, Web of Science and Cochrane Library for randomized controlled trials. The outcome measures included visual analog scale, morphine consumption, quadriceps strength, length of hospitalization and postoperative adverse events. The risk of bias of randomized controlled trials was assessed according to the Cochrane Risk of Bias Tool. All quantitative syntheses were completed using STATA version 14. RESULTS: Seven randomized controlled trials involving a total of 643 patients were included in our meta-analysis. The present meta-analysis indicated that there were no significant differences between the 2 groups in terms of postoperative pain score, opioid consumption, length of hospitalization or adverse effects after anterior cruciate ligament reconstruction. However, adductor canal block showed superior quadriceps strength and range of motion in the early postoperative period. CONCLUSION: Adductor canal block shows similar and adequate analgesia compared to the femoral nerve block in anterior cruciate ligament reconstruction and adductor canal block can preserve a higher quadriceps strength and better range of motion.