الفهرس 
ANATOMY OF SAPHENOUS NERVE AND ADDUCTOR CANALOnly 14 pages are availabe for public view
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Abstract
Knee arthroscopy (KA) is associated with significant postoperative pain. The need for effective analgesia without compromising function is a priority. However, despite the effectiveness of this approach, the rehabilitation of limbs after a KA operation still faces critical challenges. Pain is the most difficult factor to control following KA; however, the development of an ultrasound- guided nerve block and multi- modal analgesia and motor-sparing regional anesthetic blocks has helped to reduce postoperative pain to a certain extent to help achieve early limb autonomous movement and facilitates early knee range of motion (ROM), speed up the rehabilitation process, reduces overall narcotic consumption, shorten hospital stays, and improve patient satisfaction.
The saphenous nerve block via the adductor canal approach can be successfully used to block the medial sides of the foot and the ankle after foot and ankle surgeries, either as a solo block or in addition to the popliteal nerve block. The adductor canal block (ACB) can spare quadriceps muscle strength.
The aim of this study is to compare the analgesic effect of Bupivacaine and Bupivacaine/nalbuphine in adductor canal block in patients undergoing knee arthroscopy as regard post operative pain management.
The study was conducted on 50 random patients who were scheduled to undergo knee arthroscopy and were divided into 2 equal groups:
group B:
Patients in group B (n = 25) will receive spinal anesthesia followed by ACB with Bupivacaine alone at the end of the operation with 30ml bupivacaine (0.5%) under complete aseptic conditions.
group B/N:
Patients in group B/N (n = 25) will receive spinal anesthesia followed by ACB with Bupivacaine and Nalbuphine at the end of the operation with 30ml bupivacaine (0.5%) plus 10mg Nalbuphine diluted in 2ml normal saline under complete aseptic conditions.
The two groups were adequately monitored and assessed post-operatively for 24 hours and they were compared regarding NRS postoperative, by recording time for first for analgesic need and total consumption of opioid. Side effects were also monitored and compared.
As for the comparison between effect of Adductor canal block with Bupivacaine alone and Bupivacaine with Nalbuphine as regard post-operative pain in knee arthroscopy, it showed that Adductor canal block with Nalbuphine has more analgesic effect regarding pain assessment and also with significant difference regarding the time of first analgesia postoperative and Total analgesics consumption (in mg.) over 24-hour period post-operative, but there was so significant difference regarding post operative complications such as hypotension, nausea and vomiting.
CONCLUSION
A
s for the comparison between effect of Adductor canal block with Bupivacaine alone and Bupivacaine with Nalbuphine as regard post-operative pain in knee arthroscopy, it showed that that Adductor canal block with Nalbuphine has more analgesic effect regarding pain assessment and also with significant difference regarding the time of first analgesia postoperative and Total analgesics consumption (in mg.) over 24-hour period post-operative, but there was no significant difference regarding post operative complications such as hypotension, nausea and vomiting.