Optimal Analgesia for Total Knee

Discover how these advanced pain control methods can revolutionize patient recovery, reduce opioid dependence, and enhance overall satisfaction for TKA patients, as Dr Hadzic dissects the differences among the femoral block, femoral triangle block and adductor canal block. The video may shape your practice of interventional analgesia.
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Disclaimer:
Medicine is an ever-changing science. As new research and clinical experience broaden, changes in treatment and drug therapy are required. The authors and publishers have checked with sources believed to be reliable in efforts to provide accurate information within the available or accepted standards of care. However, given the possibility of human error or changes in medical practice, neither the authors nor the publisher, nor any other party involved in the preparation of this platform warrants that the information contained herein is in every aspect accurate or complete, and they disclaim all responsibility for any errors or omissions for the results obtained from the use of the information contained in this work. Readers are advised to confirm the information contained herein with other sources. For example, readers are advised to check the product information of each drug mentioned, and that any information contained on NYSORA's RUclips channel is accurate.

[@drnairforspeed]

Here what we use is Femoral triangle block plus ipack. Good results.

[@DrTuhinM]

We use Dual Subsartorial Block (DSB) with MMA to cover all the procedure specific innervation and provide motor-sparing, opioid-sparing postoperative analgesia.

[@nysoravideo]

Thank you for sharing your experiences! Greetings from NYSORA!

[@przemekdzido9601]

Hello! For me the best choice is to add Ipack block to Femoral Triangle Block...

[@nysoravideo]

Good choice. Do your colleagues do the same?

[@przemekdzido9601]

Usually Femoral Triangle / Adductor Canal plus local periarticular infiltration intraoperatively...

[@user-cq5mj6oi1m]

🎉🎉

[@rishiraj2548]

🙂🙏🏻

[@alicerenieri329]

Hello...can you do a video about the optimal local anesthetic choice in labour analgesia for parturients with glucose6 phosphate dehydrogenase deficit? Here in Italy there are many people with this condition...
Thank you very much

[@nysoravideo]

Thank you. This is a great suggestion, we will definitely put this on our list. Greetings to you and all your colleagues and make sure you subscribe to our channel so you don't miss these upcoming videos. Best regards from Nysora!

[@ahmednashin456]

how about an continuous epidural analgesia with .0625% bupivacaine plus adductor canal block in Total knee replacement surgery

[@JustAnAnaesthetist]

Oxymoronic

[@stephaniebuffetti7000]

How about the use of Exparel?

[@nysoravideo]

IMO - DEFINITIVELY. That is the ONLY additive to standard local anesthetic that actually prolongs the nerve blocks.

[@nerveblock]

@@nysoravideo dexamethasone, dexmedetomidine, and buprenorphine (not that I'd use it due to side effects and access issues) don't prolong duration?

[@dgozaru]

So it isn't adductor canal block + IPACK + genicular nerve block + anterior cutaneous nerve block?

[@nysoravideo]

Ideally - YES, but practically - nearly impossible to implement as a service due to the education and time required to execute these blocks. What do you think?

[@dgozaru]

@@nysoravideo been there done that.. What I usually do are subarachnoid block -> genicular block -> surgery -> iPack, Adductor Canal/Femoral Triangle and lastly Cuties.. Took me 11 minutes total..

[@nerveblock]

@@dgozaru agree. it's not hard to be efficient with these. though I'd tend to do the FT and cuties before surgery

[@dgozaru]

@@nerveblock my Ortho tends to complain about wet operation field whenever I do FT/ACB before the surgery.. But frankly I believe that he says that just to nag me..

[@immobinvesting3347]

I generally do an adductor canal block + IPACK, and then a GA or a Rachianesthesia. It’s enough in most cases. The patient often doesn’t need any morphine at all after that

[@maimadkour9946]

Can we give femoral block with adductor canal block ?

[@przemekdzido9601]

What for? Ipack is better...??

[@nysoravideo]

Once you do femoral block, no need for adductor canal block, as the saphenou snerve is already blocked with the femoral