Efficacy of Saphenous nerve block in comparison to analgesics requirements for post operative pain after arthroscopic ACL repair

Abstract

Arthroscopic knee surgery is a minimally invasive technique associated with moderate pain during the first 24 hrs post-surgery. Effective pain control after reconstruction of the anterior cruciate ligament (ACL) requires a multimodal approach including opiates, peripheral nerve blocks, and a local anesthetic injection into the hamstring donor site or knee. Opiates are associated with many side effects (i.e., nausea, vomiting, dizziness, and vertigo) that may prevent early mobilization. Local anaesthesia techniques therefore hold appeal as a means of decreasing opiate requirements. Good pain management is achieved with different peripheral nerve block techniques. The saphenous nerve is a branch of the femoral nerve, which provides sensory innervations to the peripatellar region and the medial side of the leg, below the knee. It provides cutaneous innervations to the anterior, anteromedial and posteromedial sides of the leg from the knee to the ankle. The introduction of ultrasound technology gives surgeons a clear view of the nerve, which greatly facilitates blockage techniques guided by the adductor canal and femoral artery.