Adductor canal for acl

[GaseousClay]

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lots of surgeons I come across now don't feel like a block is necessary for ACL reconstructions. Are you guys blocking for these cases? I see some small studies showing no diff with adc block vs saline for acl and arthroscopic surgeries.

 

[Hoya11]

Blocking with FNB then they go home, outpt procedure, ~80% of our surgeons want this block vs a possible admission for pain control

 

[Noyac]

Depends somewhat of the ACL repair. BTB (patella graft) definitely needs block for most pts. Hamstring may be doable without for some pts. Allograft may be even more doable without block.

We do mostly BTB so they all get some sort of block.

 

[GaseousClay]

not sure but im feeling like blocks are growing out of favor as surgeons i believe are getting paid more to do these post op injections with exparel and what not. this past acl i did surgeon gave 50ml of 0.25% marcaine, 0.5% lido and exparel. there would have been no way i could do the block anyhow.

 

[Scotty_G]

We do mostly adductor canal for ACL's because they are going home.

 

[deleted162650]

Our guys like ACB's for ACL's. I've offered to do high sciatics (sub-gluteal) to cover the hammy graft but they're not interested. Pts seem to do fine without so I haven't pressed the issue.

 

[Consigliere]

FNB

 

[dhb]

I find it very surgeon and procedure dependant: with one surgeon, patient always had significant pain in the sciatic distribution and for another they did great with just a ACB...

 

[deleted162650]

I find it very surgeon and procedure dependant: with one surgeon, patient always had significant pain in the sciatic distribution and for another they did great with just a ACB...

Even with TKA's I notice a stark difference in post-op pain between surgeons.