Palabras clave
Anestesia de conducción
Artroplastia de reemplazo de rodilla Analgesia
Anesthesia
Conduction
Arthroplasty
Replacement
Knee
Cómo citar
Resumen
La artroplastia de rodilla es una cirugía que se realiza de manera frecuente y rutinaria a nivel mundial. La incidencia de esta cirugía viene en aumento, posiblemente por la inversión de la pirámide poblacional y el aumento de comorbilidades como la obesidad, que hace que la patología articular de rodilla sea más frecuente. Usualmente, los pacientes llevados a artroplastia de rodilla cursan con dolor post operatorio moderado a severo que se puede cronificar, produciéndose un dolor post quirúrgico persistente, con implicaciones negativas en la calidad de vida, satisfacción, rehabilitación y desenlaces en el paciente. Por tal motivo, las técnicas analgésicas utilizadas para reducir el dolor postoperatorio en estos pacientes en un contexto de analgesia multimodal son fundamentales para reducir la probabilidad de eventos negativos posteriores al procedimiento. El objetivo del presente artículo es describir la técnica del bloqueo del canal de los aductores como estrategia analgésica perioperatoria en artroplastia de rodilla.
Citas
Karlsen APH, Wetterslev M, Hansen SE, Hansen MS, Mathiesen O, Dahl JB. Postoperative pain treatment after total knee arthroplasty: A systematic review. PLoS ONE 2017; 12 (3): e0173107. https://doi.org/10.1371/journal.pone.0173107
Byrne K., ClarkJ. Total knee arthroplasty - The optimal analgesic regime. Trends in Anaesthesia and Critical Care. 2015; (5): 104-110 https://doi.org/10.1016/j.tacc.2015.04.004
Fischer HBJ, Simanski CJP, Sharp C, Bonnet F, Camu F, Neugebauer E, et al. A procedure-specific systematic review and consensus recommendations for postoperative analgesia following total knee arthroplasty. Anaesthesia. 2008;63(10):1105-23. https://doi.org/10.1111/j.1365-2044.2008.05565.x
Quamar Azam, Mir Sadat Ali, Ahmad Badar. Pain management in Knee arthroplasty Overview. Current Orthopaedic Practice. 2016; 27 (4): 360 - 370 https://doi.org/10.1097/BCO.0000000000000391
Dong C-C, Dong S-L, He F-C. Comparison of Adductor Canal Block and Femoral Nerve Block for Postoperative Pain in Total Knee Arthroplasty.Medicine (Baltimore). 2016;95(12):e2983. https://doi.org/10.1097/MD.0000000000002983
Burckett-St Laurant D, Peng P, Girón Arango L, Niazi AU, Chan VWS, Agur A, et al. The Nerves of the Adductor Canal and the Innervation of the Knee: An Anatomic Study. Reg Anesth Pain Med. 2016;41(3):1. https://doi.org/10.1097/AAP.0000000000000389
Shah NA, Jain NP, Mch MS, Jain NP. Is continuous adductor canal block better than continuous femoral nerve block after total knee arthroplasty? Effect on ambulation ability, early functional recovery and pain control: A randomized controlled trial. J Arthroplasty. 2014;29(11):2224-9 https://doi.org/10.1016/j.arth.2014.06.010
Turbitt L., Choi S., McCartney C. Analgesic Techniques for Total Knee Arthroplasty. Advances in Anesthesia. 2015; 33: 77-96 https://doi.org/10.1016/j.aan.2015.07.005
Lund J, Jenstrup MT, Jæger P, Sørensen AM, Dahl JB. Continuous adductor-canal-blockade for adjuvant post-operative analgesia after major knee surgery: Preliminary results. Acta Anaesthesiol Scand. 2011;55(1):14-9. https://doi.org/10.1111/j.1399-6576.2010.02333.x
Van der Wal M, Lang SA, Yip RW. Transsartorial approach for saphenous nerve block. Can J Anaesth. 1993;40(6):542-6. https://doi.org/10.1007/BF03009739
Horn J-L, Pitsch T, Salinas F, Benninger B. Anatomic basis to the ultrasound-guided approach for saphenous nerve blockade. Reg Anesth Pain Med. 2009;34(5):486-9. https://doi.org/10.1097/AAP.0b013e3181ae11af
Li D, Ma G guang. Analgesic efficacy and quadriceps strength of adductor canal block versus femoral nerve block following total knee arthroplasty. Knee Surgery, Sport Traumatol Arthrosc. 2015;24(8):1-6. https://doi.org/10.1007/s00167-015-3874-3
Hunter L, Louis DS, Ricciardi JR, Connor GAO. The saphenous nerve: its course and importance in medial arthrotomy. Am J Sports Med. 1979;7(4):227-30.https://doi.org/10.1177/036354657900700403
Romanoff M, Cory P, Kalenak A, Keyser G, Marshall W. Saphenous nerve entrapment at the adductor canal. Am J Sports Med. 1989;17(4):478 - 81 https://doi.org/10.1177/036354658901700405
Jiang X, Wang Q, Wu C, Tian W. Analgesic Efficacy of Adductor Canal Block in Total Knee Arthroplasty: A Meta-analysis and Systematic Review.Orthop Surg. 2016;8(3):294-300. https://doi.org/10.1111/os.12268
Gao F, Ma J, Sun W, Guo W, Li Z. Adductor canal block versus femoral nerve block for analgesia after total knee arthroplasty: A systematic review and meta- analysis. Clin J Pain. 2017 Apr;33(4):356-368 https://doi.org/10.1097/AJP.0000000000000402
Wang D, Yang Y, Li Q, Tang S, Zeng W, Xu J, et al. Adductor canal block versus femoral nerve block for total knee arthroplasty: a meta-analysis of randomized controlled trials. Sci Rep. 2017; 7: 40721. https://doi.org/10.1038/srep40721
Machi AT, Sztain JF, Kormylo NJ, Madison SJ, Abramson WB, Monahan AM, et al. Discharge Readiness after Tricompartment Knee Arthroplasty: Adductor Canal versus Femoral Continuous Nerve Blocks-A Dual-center, Randomized Trial. Anesthesiology 2015 08;123(2):444-456. https://doi.org/10.1097/ALN.0000000000000741
Horner G, Dellon AL. Innervation of the human knee joint and implications for surgery. Clin Orthop Relat Res. 1994 Apr;6(301):221-6. https://doi.org/10.1097/00003086-199404000-00034
Chambers G. The prepatellar nerve: A cause of suboptimal results in knee arthrotomy. Clin Orthop. 1972; 82:157-159. https://doi.org/10.1097/00003086-197201000-00021
Fulkerson, J., Grossling, H. Anatomy of the knee joint lateral retinaculum. Clin. Orthop. 1980: 153:183-8. https://doi.org/10.1097/00003086-198011000-00025
Elliott CE, Thobhani S. The adductor canal catheter and interspace between the popliteal artery and the posterior capsule of the knee for total knee arthroplasty. Tech Reg Anesth Pain Manag. 2014;18(4):126-9 https://doi.org/10.1053/j.trap.2015.10.011
Gautier PE, Hadzic A, Lecoq JP, Brichant JF, Kuroda MM, Vandepitte C. Distribution of Injectate and Sensory-Motor Blockade after Adductor Canal Block. Anesth Analg. 2016;122(1):279-82. https://doi.org/10.1213/ANE.0000000000001025
Bauer MCR, Pogatzki-Zahn E, Zahn PK. Regional analgesia techniques for total knee replacement. Current opinion in anaesthesiology 2014 10;27(5):501-506. https://doi.org/10.1097/ACO.0000000000000115
Chen J, Li N, Xu Y. Single Shot Adductor Canal Block for Postoperative Analgesia of Pediatric Patellar Dislocation Surgery: A Case-Series Report. Medicine 2015 12;94(48):1. https://doi.org/10.1097/MD.0000000000002217
Vora MU, Nicholas TA, Kassel CA, Grant SA. Adductor canal block for knee surgical procedures: review article. J Clin Anesth 2016;35:295-303. https://doi.org/10.1016/j.jclinane.2016.08.021
Espelund M, Grevstad U, Jaeger P, Hölmich P, Kjeldsen L, Mathiesen O, et al. Adductor canal blockade for moderate to severe pain after arthroscopic knee surgery: a randomized controlled trial. Acta Anaesthesiol Scand 2014 11;58(10):1220-1227. https://doi.org/10.1111/aas.12407
Abdallah FW, Whelan DB, Chan VW, Prasad GA, Endersby RV, Theodoropolous J, et al. Adductor Canal Block Provides Noninferior Analgesia and Superior Quadriceps Strength Compared with Femoral Nerve Block in Anterior Cruciate Ligament Reconstruction. Anesthesiology 2016 05;124(5):1053-1064. https://doi.org/10.1097/ALN.0000000000001045
Ilfeld BM. Continuous Peripheral Nerve Blocks: An Update of the Published Evidence and Comparison with Novel, Alternative Analgesic Modalities. Anesth Analg 2017 01;124(1):308-335 https://doi.org/10.1213/ANE.0000000000001581