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The effects of ultrasound-guided adductor canal block versus femoral nerve block on quadriceps strength and fall risk: a blinded, randomized trial of volunteers.

Publication ,  Journal Article
Kwofie, MK; Shastri, UD; Gadsden, JC; Sinha, SK; Abrams, JH; Xu, D; Salviz, EA
Published in: Reg Anesth Pain Med
2013

BACKGROUND AND OBJECTIVES: Adductor canal block (ACB) has been suggested as an analgesic alternative to femoral nerve block (FNB) for procedures on the knee, but its effect on quadriceps motor function is unclear. We performed a randomized, blinded study to compare quadriceps strength following adductor canal versus FNB in volunteers. Our hypothesis was that quadriceps strength would be preserved following ACB, but not FNB. Secondary outcomes included relative preservation of hip adduction and degree of balance impairment. METHODS: The ACB was performed in one leg and the FNB in the contralateral leg in 16 volunteers using a randomized block sequence. For all blocks, 15 mL of 3% chloroprocaine was injected under ultrasonographic guidance. Maximal voluntary isometric contraction of knee extension and hip adduction was measured at baseline and at 30 and 60 minutes after block. After 60-minute assessments were complete, the second block was placed. A test of balance (Berg Balance Scale) was performed 30 minutes after the first block only. RESULTS: Quadriceps strength and balance scores were similar to baseline following ACB. Following FNB, there was a significant reduction in quadriceps strength (95.1% ± 17.1% vs 11.1% ± 14.0%; P < 0.0001) and balance scores (56 ± 0 vs 37 ± 17.2; P = 0.02) compared with baseline. There was no difference in hip adductor strength (97.0% ± 10.8% vs 91.8% ± 9.6%; P = 0.17). CONCLUSIONS: Compared with FNB, ACB results in significant quadriceps motor sparing and significantly preserved balance.

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Published In

Reg Anesth Pain Med

DOI

EISSN

1532-8651

Publication Date

2013

Volume

38

Issue

4

Start / End Page

321 / 325

Location

England

Related Subject Headings

  • Young Adult
  • Ultrasonography, Interventional
  • Time Factors
  • Range of Motion, Articular
  • Quadriceps Muscle
  • Procaine
  • Postural Balance
  • New York City
  • Nerve Block
  • Muscle Strength
 

Citation

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Kwofie, M. K., Shastri, U. D., Gadsden, J. C., Sinha, S. K., Abrams, J. H., Xu, D., & Salviz, E. A. (2013). The effects of ultrasound-guided adductor canal block versus femoral nerve block on quadriceps strength and fall risk: a blinded, randomized trial of volunteers. Reg Anesth Pain Med, 38(4), 321–325. https://doi.org/10.1097/AAP.0b013e318295df80
Kwofie, M Kwesi, Uma D. Shastri, Jeff C. Gadsden, Sanjay K. Sinha, Jonathan H. Abrams, Daquan Xu, and Emine A. Salviz. “The effects of ultrasound-guided adductor canal block versus femoral nerve block on quadriceps strength and fall risk: a blinded, randomized trial of volunteers.Reg Anesth Pain Med 38, no. 4 (2013): 321–25. https://doi.org/10.1097/AAP.0b013e318295df80.
Kwofie MK, Shastri UD, Gadsden JC, Sinha SK, Abrams JH, Xu D, et al. The effects of ultrasound-guided adductor canal block versus femoral nerve block on quadriceps strength and fall risk: a blinded, randomized trial of volunteers. Reg Anesth Pain Med. 2013;38(4):321–5.
Kwofie, M. Kwesi, et al. “The effects of ultrasound-guided adductor canal block versus femoral nerve block on quadriceps strength and fall risk: a blinded, randomized trial of volunteers.Reg Anesth Pain Med, vol. 38, no. 4, 2013, pp. 321–25. Pubmed, doi:10.1097/AAP.0b013e318295df80.
Kwofie MK, Shastri UD, Gadsden JC, Sinha SK, Abrams JH, Xu D, Salviz EA. The effects of ultrasound-guided adductor canal block versus femoral nerve block on quadriceps strength and fall risk: a blinded, randomized trial of volunteers. Reg Anesth Pain Med. 2013;38(4):321–325.

Published In

Reg Anesth Pain Med

DOI

EISSN

1532-8651

Publication Date

2013

Volume

38

Issue

4

Start / End Page

321 / 325

Location

England

Related Subject Headings

  • Young Adult
  • Ultrasonography, Interventional
  • Time Factors
  • Range of Motion, Articular
  • Quadriceps Muscle
  • Procaine
  • Postural Balance
  • New York City
  • Nerve Block
  • Muscle Strength