Purpose

Moderate-to-severe postoperative pain remains a challenge for both patients and surgeons after anterior cruciate ligament reconstruction (ACLR). The purpose of this study was to systematically review the current evidence in the literature to compare adductor canal block (ACB) with femoral nerve block (FNB) in the treatment of ACLR.

Methods

A comprehensive search of the published literature in PubMed, Scopus, EMBASE, and Cochrane Library databases was performed. Only English randomized clinical trials (RCTs) were included in this study. The primary outcome was pain score. Secondary outcome measures included opioid consumption, postoperative adverse events, patient satisfaction, and quadriceps strength.

Results

Eight RCTs with a total of 587 patients were included. No statistically

significant difference was observed between the ACB and FNB groups in pain scores at 6 h, 12 h, 24 h, or 48 h; cumulative opioid consumption at 24 h or 48 h; patient satisfaction at 24 or 48 h; and postoperative adverse event. However, ACB showed superior quadriceps strength in the early postoperative period.

Conclusions

Both treatments provided similar overall pain relief after ACLR. The

potential benefits of quadriceps preservation with ACB are worthy of future study.

Therefore, ACB is recommended as an attractive alternative to FNB as the peripheral nerve block of choice for ACLR.

Level of evidence

Meta-analysis of Level 1 was performed in this study.

目的

术后前交叉韧带重建（ACLR）对患者和外科医生而言，中度至重度术后疼痛仍然是一个挑战。这项研究的目的是系统地回顾文献中的现有证据，以比较内收管阻滞（ACB）与股神经阻滞（FNB）在ACLR的治疗中。

方法

对PubMed，Scopus，EMBASE和Cochrane图书馆数据库中已发表的文献进行了全面搜索。本研究仅包括英语随机临床试验（RCT）。主要结果是疼痛评分。次要结果指标包括阿片类药物的摄入量，术后不良事件，患者满意度和股四头肌强度。

结果

纳入八项随机对照试验，共587例患者。没有统计

ACB组和FNB组在6 h，12 h，24 h或48 h的疼痛评分上存在显着差异；24小时或48小时的累计阿片类药物消耗量；24或48小时的患者满意度；和术后不良事件。但是，ACB在术后早期显示出优越的股四头肌强度。

结论

两种治疗在ACLR后可提供相似的总体止痛效果。的

ACB保四头肌的潜在益处值得未来研究。

因此，ACB被推荐作为FNB的诱人替代品，作为ACLR的首选周围神经阻滞。

证据水平

在这项研究中进行了1级的荟萃分析。