Continuous ambulatory adductor canal catheters for patients undergoing knee arthroplasty surgery

Neil A Hanson, Phoebe H Lee, Stanley C Yuan, Daniel S Choi, Cindy Jo Allen, David B Auyong
Journal of Clinical Anesthesia 2016, 35: 190-194

STUDY OBJECTIVE: To determine after knee arthroplasty surgery the feasibility of discharging patients home on postoperative day 1 with continuous adductor canal blocks.

DESIGN: Retrospective case series.

SETTING: Outpatient setting after hospital discharge.

PATIENTS: Patients undergoing knee arthroplasty surgery from October 2013 to August 2014.

INTERVENTIONS: All patients received continuous adductor canal catheters for postoperative analgesia and were discharged to home on postoperative day 1. Continuous catheters were intended to remain intact in the ambulatory setting through postoperative day 3.

MEASUREMENTS: Data obtained included demographic information, duration of hospital stay, resting and active pain scores, opioid utilization, opioid-induced adverse effects, complications relating to the perineural catheter, and hospital readmissions.

MAIN RESULTS: Sixty-nine of 582 patients (11.9%) were discharged to home on postoperative day 1. The median numerical pain score after discharge with a continuous adductor canal block was ≤2 at rest and ≤4 with activity. After block discontinuation on postoperative day 4, median pain scores were the same. No patients reported any unintentional catheter dislodgements, falls, or dysesthesias. There were no readmissions of any patient in this cohort within 90 days of surgery.

CONCLUSIONS: Ambulatory adductor canal catheters are a feasible analgesic modality after knee arthroplasty surgery as pain scores remained low and adverse events were minimal.

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